• How Does HIV/AIDS Affect the Eye?

    Written By:
    Reviewed By: Ninel Z Gregori MD
    Mar. 27, 2020

    Because HIV causes a breakdown of your body’s immune system, all areas of the body can get an infection. This includes the eye. People with HIV who are otherwise in good health are not likely to have eye problems related to a suppressed immune system. But an estimated 70 percent of patients with advanced AIDS experience eye disorders.

    AIDS-related eye problems due to a suppressed immune system can include the following:

    HIV retinopathy

    This is the most common finding in people with AIDS. Cotton-wool spots and blood from broken blood vessels appear on the retina. Ophthalmologists 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. A virus called cytomegalovirus (CMV) 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 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 detached retina. This is where the retina pulls away, or detaches, from the back of the eye. A detached retina is a serious problem that causes severe vision loss unless treated. Almost all retinal detachments need detached retina 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. Ophthalmologists 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 ophthalmologist.