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. Small hemorrhages and cotton wool spots (white spots as a result of a blood vessel blockage) are seen in the retina—the light-sensitive tissue lining the back of your eye. It is thought that the HIV virus is directly responsible for these changes to the small blood vessels in the retina.

CMV retinitis

A more serious eye infection that occurs in about 20 to 30 percent of people with AIDS is CMV retinitis. It is caused by a virus called cytomegalovirus (CMV). It usually occurs in people who have more advanced stages of AIDS in which T-cell count is very low. Symptoms include swelling (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 (Eye M.D.) immediately if you experience:

  • floating spots or “spider-webs”;
  • flashing lights;
  • blind spots or blurred vision.

CMV retinitis cannot be cured, but progression of the virus can be slowed with medication.

Detached retina

CMV can sometimes cause detached retina, 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 require detached retina surgery to put the retina back in its proper position.

Kaposi’s sarcoma

Kaposi's sarcoma is a rare form of cancer that occurs in AIDS patients. This cancer can cause purple-red lesions to form on the eyelids, or a red, fleshy mass to form on the conjunctiva—the thin, filmy membrane that covers the white part of your eye. Kaposi’s 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, the thin membrane that covers the white of the eye. Studies have shown this condition to be related to HIV/AIDS infection, prolonged exposure to sunlight, and infection with the human papilloma virus (HPV).

Increased risk of various eye infections

A number of eye infections, some associated with sexually transmitted diseases and others that are not, may be more common in patients with HIV. Some of these infections may include herpes virus, gonorrhea, Chlamydia, toxoplasmosis, Candida, Pneumocystis, microsporidia, and others. These infections can threaten vision and require treatment by an Eye M.D.

Image reprinted, with permission, from Holds JB, Basic and Clinical Science Course, Section 7, American Academy of Ophthalmology, 2011-2012.

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