About 75% of AIDS (Acquired Immunodeficiency Syndrome) patients develop eye problems of some sort. The retina (the light-sensitive membrane at the back of the eye) is most commonly affected. Tiny retinal hemorrhages and cotton-wool spots are early signs of infection and are often detected during an eye exam. A cotton-wool spot, which looks white and fluffy, is caused by a circulatory disturbance in a tiny area of the retina. This disturbance may also cause small blood spots or hemorrhages. Since other diseases can produce the same findings, cotton-wool spots and tiny retinal hemorrhages are not diagnostic of AIDS.
Infection of the retina with the cytomegalovirus (CMV) is more serious. CMV is known as an opportunistic infection because it rarely causes disease except in people whose immune system is damaged. CMV kills retinal cells by moving from one cell to another. The entire retina may become involved within a period of two to three months. If the infection does not respond to treatment and is present in both eyes, it can lead to blindness. Other infections of the retina, including infections with the Herpes virus, the parasite Toxoplasma, and the fungus Candida, can also occur in AIDS patients.
Kaposi's sarcoma is a rare form of cancer that occurs in AIDS patients. It may involve the eyelids, where it appears as a non-tender purple nodule. If it affects the conjunctiva, the mucus membrane that covers the white of the eye, it appears as a bright red fleshy mass. Kaposi's sarcoma lesions of skin and mucus membrane tend to grow slowly.
In the final stages of the disease, the brain is frequently involved, either with direct infection by HIV or with opportunistic infections. Because over 50% of the human brain is concerned in some way with the act of seeing, the eyes may show signs of brain involvement. Blurred vision, problems with eye movement, or double vision may result.
What About The AIDS Virus In Tears?
The HIV virus has rarely been found in tears of AIDS patients and no known case of AIDS has ever occurred because of tear contact. However, ophthalmologists are being especially careful in cleaning contact lenses and instruments which come in contact with the tears. It is reassuring to know that all commercially available contact lens cleaning solutions tested in a recent study found to disinfect contact lenses which had been exposed to the HIV virus.
- Blurred vision
- Double vision
- Problems with eye movement
- Growths on the eye
- Eye pain
- Decreased vision
If you suspect that you might be HIV-positive or have AIDS, contact your doctor immediately for a complete examination.
Ophthalmologists are frequent consultants in the care of AIDS patients. Detection of retinal cotton-wool spots and hemorrhage can be useful in detecting AIDS. No treatment is necessary for retinal cotton-wool spots or hemorrhage because they do not affect vision. Ganciclovir, delivered ocularly or systemically, is used to stop the progression of CMV retinal infection and may prevent vision loss. The growth of Kaposi's sarcoma spots may be slowed by radiation treatment or surgical excision.