A 22-year-old man with a recorded history of mpox presented with right-eye pain and reduced vision of approximately one month's duration. Clinical notes, anterior segment photographs, and two in vivo confocal microscopy reports were reviewed. Mpox should be considered in the differential diagnosis of prolonged or recurrent unilateral keratitis in patients with a documented history of infection, particularly when the clinical course is atypical or fluctuating. This case highlights the potential for delayed ocular involvement and the importance of careful clinical assessment for keratitis with a history of mpox.