Systemic and Ophthalmic Manifestations of West Nile Virus Infection

Yos Priestley; Marcia Thiel; Steven B. Koevary


Expert Rev Ophthalmol. 2008;3(3):279-292. 

In This Article


West Nile virus infection can have serious systemic and ocular effects, both acute and chronic. Ocular symptoms may be treated with topical corticosteroids, but seem to be self-limited in most cases. In rare cases, ocular involvement has led to a permanent decrease in vision acuity and fields. Since there is currently no approved treatment or vaccine for WNV, the CDC strongly encourages preventative methods by communities and individuals who are at greatest risk of exposure. WNV should be included in the differential diagnosis, especially during the months of August and September when infection rates are highest or if an outbreak is occurring in the area. If WNV is confirmed or suspected as part of the differential diagnosis, a dilated fundus exam is extremely important. Due to the high incidence of chorioretinal lesions in patients with confirmed WNV infection, the presence of lesions in a patient with history of mosquito bites followed by fever, lethargy, malaise or rash strongly indicates WNV infection. However, other ocular symptoms such as anterior uveitis and vitritis may be present in the absence of lesions so a diagnosis of WNV should not be ruled out if lesions are not present.


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