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 AIDS-Related Eye Disorders

What is visual AIDS?
What are the eye-related symptoms of AIDS?
How are AIDS-related eye disorders treated?

What is AIDS?

Acquired Immunodeficiency Syndrome (AIDS) is a disease caused by the human immunodeficiency virus (HIV) that attacks T-cells. These lymphocytes, or white blood cells, are essential to the body's immune defense syndrome.

Infection with HIV does not immediately result in AIDS, but most infected persons develop the disease over a period of years. About 70 percent of HIV-infected individuals develop AIDS within 15 years.

The gradual deterioration of the immune system leaves the HIV-infected person vulnerable to damage from microorganisms that the body ordinarily handles with ease. There are many effects on the eyes.

What are the eye-related symptoms of AIDS?

There are a number of eye-related symptoms caused by AIDS:

  • cotton wool spots -- a consequence of bleeding and white spots in the retina, resulting from inflammation of the blood vessels of the retina. Cotton wool spots, named after their appearance, are not dangerous and often disappear in a matter of weeks.

  • red eye -- infections that last for a long time and cause reddening of the eyes.

  • Kaposi's sarcoma -- a noncancerous tumor that can appear on any part of the body, including the eyes. In the eye, a Kaposi's sarcoma appears as a purple-red bump on the eyelid or a spot on the sclera, the white of the eye. This growth can be treated with radiation, laser therapy, or the freezing treatment called cryotherapy.

  • herpes, toxoplasmosis, and zoster -- eye infections that are common in AIDS patients

  • CMV retinitis -- an infection caused by the cytomegalovirus. It is the most serious AIDS-related eye disorder. This retinitis can occur in as many as 30 percent of AIDS patients and is more prevalent as the disease progresses and the number of protective T-cells declines. The symptoms of CMV infection include floating spots, or "spider webs," flashing lights, blind spots, and blurred vision. Any of these symptoms should be brought to the attention of a doctor immediately. But CMV retinitis can also occur without such symptoms, so it is important for anyone with AIDS to have regular eye examinations, because the disease can cause permanent eye damage.

How are AIDS-related eye disorders treated?

CMV infection is commonly treated with two drugs, Ganciclovir and Foscarnet. These drugs slow the progress of the disease but do not eliminate it. If only one eye is infected with CMV, drug treatment can prevent infection of the other eye. The drugs used to treat CMV infection are expensive, costing $50,000 or more a year per patient, and they must be taken indefinitely.

Results of a 1999 study by the National Eye Institute offer hope for some AIDS patients with CMV retinitis. The study found that a cocktail of drugs called HAART, an acronym for highly active antiretroviral therapy, can rejuvenate the immune system to the point where some patients can stop taking anti-CMV medications and their CMV retinitis does not become worse. The study tracked 14 patients with CMV retinitis taking HAART. After two years of not taking standard anti-CMV medications, none of patients showed any progression of their retinitis. Some patients did experience uveitis and eye inflammation, as the immune system became more powerful under HAART treatment.

Although HIV can be found in tears, as well as in all other body fluids, it cannot be transmitted by contact with tears of an infected person. HIV infection is contracted only by close personal contact - having unprotected sex with an infected person, sharing hypodermic needles, getting a transfusion of virus-carrying blood, or being born to a mother infected with HIV. Nevertheless, ophthalmologists and other physicians who treat HIV-infected persons keep all instruments and surfaces sterile and disinfected. Diagnostic contact lenses are cleaned to kill any HIV and prevent transmission of the infection.

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