AIDS Presenting in an Adolescent Male With Persistent Conjunctivitis and Eye Pain

An adolescent male with persistent conjunctivitis and an episcleral nodule presented with new-onset focal seizures and headaches. The patient was found to have cotton wool spots and papilledema on retinal examination. He was ultimately diagnosed with HIV retinopathy and AIDS. Ocular manifestations are rare presenting symptoms of AIDS among adolescents in the United States. Ocular disease in pediatric HIV/AIDS patients is most often caused by opportunistic infections. HIV retinopathy, the most common cause of blindness in patients with HIV, is usually a late disease manifestation. It is important for providers caring for adolescents to be aware of the potential ocular manifestations of HIV/AIDS. Teenagers are less likely to be aware of their HIV status and less likely to be tested for HIV, despite high risk exposures, and therefore, universal and routine HIV screening is recommended for all patients.