Zika Virus and the Eye

Bruno de Paula Freitas; Camila V. Ventura; Mauricio Maia; Rubens Belfort Jr


Curr Opin Ophthalmol. 2017;28(6):595-599. 

In This Article

Abstract and Introduction


Purpose of review: The aim of this study was to review the ocular findings related to the Zika virus (ZIKV) based on the main studies published to date, describe the patterns of the lesions and risk factors, and identify the public health implications and scientific importance of this emerging disease.

Recent findings: In most studies, the ZIKV seems related to congenital ocular lesions and most mothers reported mild symptoms during the first pregnancy trimester. Five fundus patterns were seen most often: macular chorioretinal atrophy, chorioretinal atrophy elsewhere, focal pigmentary changes in the macular region, optic nerve abnormalities and combined types. A few studies have suggested that the ZIKV might damage the anterior segment of these babies' eyes. Few reports have described the ocular complications seen in adults during the acute infection, including conjunctivitis, iridocyclitis and chorioretinitis.

Summary: Infants with congenital Zika syndrome might have vision-threatening fundus abnormalities. Although the full spectrum of ocular lesions caused by the ZIKV infection is not yet determined, a distinctive new disease has been observed. Recognition of these lesions by ophthalmologists can help ensure appropriate etiologic evaluation and clinical investigation to define the range of anomalies in an affected infant and determine essential follow-up and ongoing care.


Ocular anomalies have been reported in infants with presumed and laboratory-confirmed prenatal Zika virus (ZIKV) infection.[1,2,3,4,5] Posterior findings have been the most prevalent, but some studies have reported that anterior segment and structural defects also might be related.[2,4,5] Larger series of 20 or more infants with presumed ZIKV-associated microcephaly have reported ocular findings in 34–55% of patients.[2,6] Some retinal lesions, including well defined chorioretinal atrophy and gross pigmentation, generally affecting the macular region, have been well described and seem to suggest ZIKV infection.