When testing Molluscum contagiosum presenting with conjunctivitis, which tests may be performed?

• A. NaFl with +/- SPK, lid eversion +/- follicles, ELISA and WB if multiple and severe
• B. Bacterial culture only
• C. Intraocular pressure measurement only
• D. MRI of the orbit

Answer: (A)

When molluscum contagiosum presents with conjunctivitis, evaluation focuses on surface involvement, lid findings, and systemic status if the disease is extensive. Fluorescein staining helps assess any epithelial surface damage or keratopathy that can accompany conjunctivitis. Eversion of the eyelid is important to inspect the lid margin for molluscum lesions and any associated follicles, which guides diagnosis and management. If there are multiple or severe lesions, consider testing for potential immunodeficiency, such as HIV, using ELISA with a confirmatory Western blot if indicated. Other tests like a bacterial culture won’t identify molluscum and aren’t the primary approach here, intraocular pressure measurement targets glaucoma risk, and MRI of the orbit isn’t needed for straightforward molluscum conjunctivitis.