HIV and Low Vision: A Narrative Review.

Area of Science:

• Ophthalmology
• Infectious Diseases
• Public Health

Background:

• Human Immunodeficiency Virus (HIV) affects over 38 million globally.
• Highly Active Antiretroviral Therapy (HAART) reduced mortality but ocular complications persist.
• HIV-related low vision significantly impacts quality of life, independence, and mental health.

Purpose of the Study:

• To provide an in-depth review of HIV-related low vision.
• To explore epidemiology, clinical spectrum, diagnostics, management, and rehabilitation.
• To highlight psychosocial challenges and the need for integrated care.

Main Methods:

• Narrative review of existing literature.
• Exploration of pathophysiological mechanisms including viral damage, opportunistic infections (e.g., CMV retinitis), neuro-ophthalmic issues, and malignancies.
• Discussion of diagnostic approaches, management strategies, and rehabilitation options.

Main Results:

• HIV-related low vision arises from diverse causes, ranging from microvasculopathy to blindness.
• Ocular disease burden is high in low- and middle-income countries due to access barriers.
• Psychosocial challenges include dual stigmatization from HIV and visual impairment.

Conclusions:

• A multidisciplinary approach is essential for managing HIV-related low vision.
• Early recognition and holistic care improve functional outcomes and quality of life.
• Emerging innovations like AI diagnostics and novel drug delivery show promise.