Introduction

Cytomegalovirus (CMV) retinitis is the most common cause of blindness in AIDS patients. CMV retinitis currently affects approximately 25 % of AIDS patients. Fortunately, treatments are available for the infection to help prolong vision and reduce the trauma of blindness.

The symptoms

CMV retinitis may not cause symptoms if the affected regions are limited to the outer area of the retina. Since some patients do not experience symptoms, a visit to an eye specialist is recommended. Once diagnosed with AIDS, patients should see an eye specialist.

Symptoms that may indicate the presence of CMV retinitis include light flashes, cloudy vision, multiple small floaters (dark spots that obstruct vision) and eventual loss of central or peripheral vision. Patients who notice these symptoms should see an eye specialist immediately.

When examining an AIDS patient, doctors may also notice an inflammation of, or haemorrhaging (bleeding) within the retina (the light-sensing region that lines the back of the eye). Any damage to the retinal tissue will limit vision, and extensive impairment can cause total blindness.

Treatment

Without treatment, CMV retinitis usually progresses rapidly and can spread quickly to other parts of the eye, such as the optic nerve, which transmits images from the eye to the brain. Prompt treatment is crucial to preventing vision loss in people with CMV retinitis.

Antiviral drugs can delay the progression of AIDS-related CMV retinitis in affected individuals. Although the drugs are useful in treating CMV retinitis, they can cause side effects. Unfortunately, the drugs cannot totally rid patients of CMV retinitis.

In addition to CMV retinitis, other AIDS associated diseases or conditions can affect vision:

Kaposi’s sarcoma - most common cancer associated with AIDS with darkish tumours that can appear on the eyelid

Microsporidiosis - parasites that work their way to the cornea and can cause vision loss

Ulcerative keratitis - although uncommon, bacteria can get into the eye, causing an ulcer on the cornea and potential vision loss

Kerato Conjunctivitis Sicca (KCS) - also called dry eye syndrome, affects the tear production which can cause vision difficulties and also affects HIV patients

Herpes zoster - also called shingles and caused by a weakened immune system, can appear on or near the eyes and destroy the cornea

Molluscum contagiosum - viral lesions that can grow on the eyelid and the face

AIDS attacks the entire body - including the eyes, despite treatments that slow its progress and help patients live longer. HIV / AIDS patients should be certain to have an eye specialist as part of their healthcare team.