Eye conditions associated with AIDS

29/11/2024

Acquired immunodeficiency syndrome (AIDS), caused by the human immunodeficiency virus (HIV), significantly impacts various systems of the human body, including the eyes. Patients living with HIV/AIDS may develop a variety of eye complications that affect their vision and, in severe cases, can lead to blindness. These complications mainly result from a weakened immune system, leaving the body vulnerable to opportunistic infections and diseases that typically would not manifest in people with a healthy immune system.

Eye complications in patients with AIDS
One of the most common eye conditions in people with AIDS is cytomegalovirus (CMV) retinitis. This viral infection affects the retina, the light-sensitive layer at the back of the eye. Before the introduction of highly active antiretroviral therapy (HAART), CMV retinitis was one of the leading causes of blindness in people with HIV/AIDS. CMV infection occurs because the immune system, weakened by HIV, cannot control the dormant virus in the body, allowing it to reactivate and cause damage. Symptoms include blurred vision, black spots in the visual field, and loss of central or peripheral vision.

Other eye infections that can affect AIDS patients include toxoplasmosis and syphilis, as well as viruses from the herpes group. If not treated properly, these infections can result in permanent vision damage.

HIV retinopathy is another common condition, affecting up to 70% of AIDS patients. It manifests as small hemorrhages or cotton-wool spots in the retina, reflecting damage to the blood vessels in this region. While this condition does not always cause significant vision loss, it can indicate an advanced stage of the disease.

The treatment of AIDS-related ocular pathologies has improved significantly with the advent of HAART. This therapy reduces the HIV viral load and strengthens the immune system, decreasing the incidence of opportunistic infections. In many cases, ocular conditions such as CMV retinitis can be controlled with specific antiviral medications, administered either orally or through intraocular injections. However, regular ocular monitoring remains essential for these patients, especially those with severely compromised immune systems, to prevent and promptly treat any ocular complications.

Dr. Maria José Capella, Ophthalmologist at the Barraquer Ophthalmology Centre