What are the anterior segment ocular manifestations of HIV infection?

Updated: Jun 12, 2019
  • Author: Robert A Copeland, Jr, MD; Chief Editor: Andrew A Dahl, MD, FACS  more...
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Answer

Answer

The concurrent presence of encephalopathy in patients with keratoconjunctivitis sicca may cause incomplete eyelid closure and decreased blink rate, leading to worsened dry eyes.

Complications of varicella-zoster virus (VZV) ocular infection include subepithelial infiltrates, stromal keratitis, disciform keratitis, uveitis, and increased intraocular pressure. Varicella keratitis is a self-limited disease. Corneal scarring may occur, but it is rare.

Stromal keratitis and uveitis occur in fewer than 10% of patients with primary herpes simplex virus (HSV) infection. Blepharoconjunctivitis may occur in patients with recurrent ocular HSV infection. It may or may not be associated with epithelial keratitis. Other complications of HSV infection include dendritic and geographic epithelial keratitis, nonnecrotizing stromal keratitis, and iridocyclitis.

Fungal keratitis may be complicated by uveitis, endophthalmitis, and/or retinitis. These complications may cause vitreous abscesses or retinal hemorrhages with or without Roth spots. In severe cases, retinal detachment may develop.

In HIV-positive patients infected with microsporidia, superficial keratoconjunctivitis is the most common complication seen.


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