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HIV and Retinopathy

Medically Reviewed by Michael W. Smith, MD on June 10, 2020

You might have heard that an HIV infection can affect your eyes. One way it does is a condition called retinopathy. This is the word doctors use to describe damage to the retina, the thin layer of light-sensitive tissue at the back of the eye.

When a person has retinopathy, the damage often happens in tiny blood vessels inside the retina.You need a healthy retina to see clearly.

The Risk of Retinopathy

Doctors don’t know exactly why this retina problem happens more often in people with an HIV infection. In some cases, secondary infections, cancerous growths, inflammation, or another condition may damage the eye. Diabetes is more common in people with HIV, and it can also bring on the eye condition.

Retinopathy, or changes in blood vessels of the retina, happens often in people with advanced HIV infection or AIDS (acquired immunodeficiency syndrome). It’s the most common reason for vision loss in people with HIV. Estimates show 70% of people with advanced HIV have signs of it.

People with symptoms of HIV disease, but not advanced, show changes to the retina about 40% of the time. In people with the virus and no symptoms, changes in the retina show up only about 1% of the time.

With early and better HIV treatment, retina problems have become less common than they used to be.

Signs of Retinopathy

Cotton-wool spots are often the first sign. They look like fluffy white patches on the retina. Other possible changes include breaks in the blood vessels of the retina.

Often a person with retinopathy won’t notice anything. An eye doctor can see it by looking closely at the eye with a special instrument.

Preventing Eye Problems

The best way to prevent eye problems is to take your HIV medicines as prescribed. People taking antiretroviral therapy (ART) for HIV can live long and healthy lives. In the United States, people with an HIV infection usually don’t progress to develop AIDS.

If you have HIV, it is a good idea to have your eyes checked regularly by an eye doctor. Make sure to tell a doctor if you notice any changes in your vision. It helps to catch any potential eye problems early. The longer they go untreated, the higher the chance of permanent vision loss.

If you have HIV and diabetes, your chances of getting retinopathy are higher. It’s even more important to take your medicines and see your eye doctor regularly.

WebMD Medical Reference

Sources

SOURCES:

American Academy of Ophthalmology: “HIV/AIDS and the Eye,” “Retinal Detachment.”

Harvard Health: “Retinopathy.”

HIV InSite: “Ophthalmic Manifestations of HIV.”

Medscape: “Ocular Manifestations of HIV Infection.”

StatPearls: “HIV Retinopathy.”

HIV.gov: “What are HIV and AIDS?”

Mayo Clinic: “Diabetic Retinopathy.”

Archives of Internal Medicine: “Antiretroviral Therapy and the Prevalence and Incidence of Diabetes Mellitus in the Multicenter AIDS Cohort Study.”

Case Reports in Ophthalmology: “A Case of Proliferative Diabetic Retinopathy with HIV Infection in Which HAART Possibly Influenced the Prognosis of Visual Function.”

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