AIDS and the eye

AIDS (Acquired Immunodeficiency Syndrome) is caused by the Human Immunodeficiency Virus (HIV).  About 75% of all AIDS patients develop some type of eye problem.

The most common eye problem in AIDS patients is ‘cotton wool spots.’ A cotton wool spot appears as a white, fluffy area in the retina and is usually caused by a circulatory disturbance within the retina.  The spots typically do not cause vision problems and can only be seen during an eye exam, but they are an excellent indicator of HIV’s presence.

Roughly 20-30% of AIDS patients will have a cytomeglavirus (CMV) infection of the retina.  This condition is quite serious and can cause vision loss if not diagnosed and treated early.  Even with treatment, CMV may lead to blindness.

Another condition that occurs in AIDS patients is Kaposi’s sarcoma, a rare cancer characterized by red or purple nodules.  Kaposi’s sarcoma can involve the eyelids and conjunctiva (the clear membrane over the white of the eye) in addition to other areas of the body.  Kaposi’s sarcoma on the skin is generally treatable, and while conjunctival lesions are more serious, they can be successfully treated by local radiation or through excision.

AIDS patients are more susceptible to herpes infections, toxoplasmosis (a parasite), histoplasmosis (a fungus), and Candida choroiditis (yeast infection of the vessels that nourish the retina).  The majority of eye infections that AIDS patients acquire do not normally cause problems in people with healthy, intact, immune systems.

The National Eye Institute has performed a series of studies on how HIV/AIDS impacts the eyes.  Direct Internet links to several studies are provided below.

Studies of Ocular Complications of AIDS (SOCA)–Ganciclovir-Cidofovir CMV Retinitis Trial (GCCRT)

Studies of the Ocular Complications of AIDS (SOCA)–Cytomegalovirus Retinitis Retreatment Trial (CRRT)

Studies of the Ocular Complications of AIDS (SOCA)–Foscarnet-Ganciclovir CMV Retinitis Trial (FGCRT)

Studies of the Ocular Complications of AIDS (SOCA)–HPMPC Peripheral CMV Retinitis Trial (HPCRT)

Studies of the Ocular Complications of AIDS (SOCA)–Longitudinal Study of Ocular Complications of AIDS (LSOCA)

Studies of the Ocular Complications of AIDS (SOCA)–Monoclonal Antibody CMV Retinitis Trial (MACRT)