[AIDS and the eye]

The acquired immune deficiency syndrome (AIDS), is a recently described irreversible dysfunction of cell-mediated immunity in homosexuals, intravenous, drug abusers, and hemophiliacs, with subsequent development of potentially lethal opportunistic infections and/or unusual neoplasms, such as Kaposi's sarcoma. A prospective evaluation of ophthalmic findings in 14 patients with AIDS revealed that 8 patients had ophthalmoscopically and biomicroscopically significant ocular abnormalities, including peripapillary cotton-wool spots of changing frequency and diameter, retinal hemorrhages, progressive cytomegaly virus (CMV) retinitis, acute destructive retinal necrosis, periphlebitis, CMV conjunctivitis and keratitis, and in one patient a conjunctival Kaposi's sarcoma. All patients with AIDS and abnormal ocular findings carry a poor prognosis. Early detection of ocular manifestations is important, since most patients with AIDS are visually asymptomatic, and the ophthalmic presentation may be the primary one, and the initiating contact leading to diagnosis and permitting the prognosis to be assessed.