Molluscum contagiosum (also known as water warts) is a common, harmless viral infection of the skin that mainly affects children. When the typical nodules form on the eyelids or near the eyelashes, they can lead to accompanying irritation of the eye and require an ophthalmological assessment.
The pathogen is the molluscum contagiosum virus, a poxvirus that spreads through direct skin contact or shared objects such as towels or toys. Children often infect one another, for example at kindergarten, at school, or during sports. Through scratching, the nodules can also spread to other parts of the body (autoinoculation).
The water warts show a characteristic appearance:
On the eye, the nodules are typically found on the eyelids, at the eyelid margins, or around the eyebrows.
As long as the water warts are at some distance from the eyelashes, they usually cause no eye problems. However, if the nodules are located directly on the eyelid margin or near the eyelashes, the released viral material can trigger a chronic conjunctivitis (follicular conjunctivitis). Affected children then have red, watery eyes.
In most cases, water warts heal on their own within 6 to 9 months, once the immune system has fought off the virus. In some children, however, they can persist for one to two years. After healing, the immune system develops a certain defense against the virus, but renewed infection is possible.
Not every water wart on the eye has to be treated. Removal is considered when:
The most common treatment methods are:
In younger children, sedation or a short general anesthesia is often necessary for treatment near the eye, in order to ensure safe and pain-free removal.