Recognizing Ocular Milker's Nodule: Diagnostic Clues and Clinical Course in Two Dairy Workers

Milker's nodule is a zoonotic infection caused by the Parapoxvirus (genus Parapoxvirus, family Poxviridae), typically affecting dairy workers through direct contact with infected cattle. Ocular involvement is rare and usually results from autoinoculation from hand lesions. We report two cases in dairy workers presenting with vesiculoulcerative eyelid lesions and corneal epithelial defects. One patient developed limbitis and stromal keratitis, which resolved completely with topical lubricants, and corticosteroids after reepithelialization. The second case healed spontaneously with conservative therapy. Ocular Milker's nodule closely mimics viral keratitis but follows a benign, self-limiting course. Recognition of characteristic hand lesions and occupational exposure is essential for accurate diagnosis and to avoid unnecessary antiviral therapy. Preventive measures include glove use, hand hygiene, and cattle vaccination.