HIV and the Eye

Blog by Ivan J. Srut, O.D.
Chief of Optometry for St. Hope Foundation

As we know, HIV causes a breakdown of your body’s immune system. This means that all areas of the body are vulnerable to infection. This includes the eye. People with HIV who are otherwise in good health will likely not have eye problems related to a suppressed immune system. However, an estimated 70 percent of patients with advanced AIDS will experience eye disorders.

Eye problems due to a suppressed immune system in advanced HIV/Aids can include the following:

HIV Retinopathy

The most common finding in people with AIDS. Cotton-wool spots and blood from broken blood vessels appear on the retina. Eye doctors think the HIV virus causes these changes to the small blood vessels in the retina.

CMV Retinitis

CMV retinitis is a more serious eye infection that occurs in about 20 to 30 percent of people with AIDS. The CMV virus(cytomegalovirus) causes it. It usually happens in people who have more advanced stages of AIDS in which T-cell count is very low. Symptoms include inflammation of the retina, bleeding and vision loss. If left undiagnosed and untreated, CMV can cause severe vision loss within a few months.

If you have HIV/AIDS, you should see your optometrist or ophthalmologist immediately if you see:

●  floating spots or “spider-webs”

●  flashing lights

●  blind spots or blurred vision

CMV retinitis cannot be cured, but medication can slow the progression of the virus.

Detached Retina

CMV can sometimes cause a retinal detachment. This is where the retina pulls away from the back of the eye. A detached retina is a serious problem that causes severe vision loss if not treated. Almost all retinal detachments need surgery to save the vision. This surgery puts the retina back in its proper position.


Kaposi Sarcoma


Kaposi sarcoma is a rare form of cancer that occurs in AIDS patients. This cancer can cause purple-red lesions to form on the eyelids. It can also cause a red, fleshy mass to form on the conjunctiva. Kaposi sarcoma may look frightening, but it usually does not harm the eye, and can often be treated.


Squamous cell carcinoma of the conjunctiva


This is a tumor of the conjunctiva. Eye researchers and doctors believe that this condition is related to several things, including HIV/AIDS infection. It is also related to prolonged sunlight exposure and human papillomavirus (HPV) infection.


Increased risk of various eye infections


Some eye infections may be more common in patients with HIV. These infections include:


●  Syphilis

●  Herpes virus

●  Gonorrhea

●  Chlamydia

●  Toxoplasmosis

●  Candida

●  Pneumocystis

●  Microsporidia

These infections can threaten vision and must be treated by an eye professional! Please take care of your eyes. It’s not all about needing glasses! Get your eye health checked as well!

Until next time…