‘World AIDS Day’ is observed on 1st December every year. AIDS (caused by HIV) has claimed more than 39 million lives so far globally. According to World Health Organization (WHO), there were about 35 million people infected with HIV at the end of the year 2013.
HIV/AIDS is one of the major health issues in the known history of mankind. Since the immunity of the patients of AIDS is compromised, they develop a variety of diseases and conditions ranging from infections to cancers.
Following are some diseases and conditions which manifest in the eyes of HIV/AIDS patients:
1. Herpes Zoster Ophthalmicus – This is a viral infection affecting the ocular surface, eyelids, forehead and scalp on one side. Although this infection is found in non-AIDS patients, it is more common in AIDS patients and the course of disease is more severe and prolonged.
2. Tumors of Conjunctiva and Cornea – They are usually found in older age group but more common in HIV positive and AIDS patients. The tumors may be squamous cell carcinoma (conjunctiva and cornea) or lymphoma (conjunctiva only).
3. Kaposi’s Sarcoma – In the eye, it is a malignant growth of conjunctiva. During the early years of AIDS epidemic, it was quite common but as effective drug therapy for HIV evolved, it is less commonly seen. It is recommended that all patients with Kaposi’s sarcoma should be tested for HIV.
4. Cytomegalovirus Retinitis – CMV affects the retina. It is a leading cause of visual loss in AIDS patients being the most common ocular infection in this patient population.
5. Fungal Infections – The most common presentation is floaters, decreased vision and pain. Pathologically there is uveal, retinal and vitreal involvement (endophthalmitis) and is commonly caused by Histoplasma capsulatum and Candida.
6. Molluscum Contagiosum – It is caused by a DNA pox virus. The lesions are in the form of raised umbilicated nodules on and around the eyelids. In otherwise healthy individuals, the number of lesions is usually less than 20 but in AIDS patients, they may be 30-40 on each eyelid.
7. Dry Eyes – AIDS patients may present with dry eyes which is caused by infiltration and damage to the lacrimal glands which normally produce aqueous part of the tear film
Though not common, some patients are first suspected and diagnosed as HIV/AIDS by an ophthalmologist when the patients’ first manifestations are ocular.