Ophthalmic disease in patients with unrecognized HIV infection

HIV disease has a long and relatively asymptomatic incubation period before the onset of AIDS. The ophthalmic manifestations of AIDS are well recognized. Little is known of the incidence or range of ophthalmic disease seen in the latent period of HIV disease. A retrospective analysis of 125 case notes of HIV 1 antibody positive patients was undertaken. Of these, 15 (12%) had previously attended the ophthalmic department, at which stage their HIV status was unknown. Eight patients were diagnosed as being HIV positive within twelve months of attending the ophthalmic department. There was a predominance of ophthalmic infections, as opposed to trauma which is the commonest cause for ophthalmic casualty referral. Some of the ophthalmic presentations seen were the initial presenting sign of HIV disease. There were also cases of serious trauma and a mixture of other ophthalmic diseases. We discuss these ophthalmic findings and their relevance to HIV disease.