This PowerPoint will help learner's know the disorders of eyes in HIV/AIDS people

1. HIV/AIDS AND THE EYE
a) Why should you tell someone who has
HIV/AIDS about their eyes?
Eye problems are common, and more than 7 out of 10
people with HIV/AIDS may have eye problems.
HIV/AIDS can affect all parts of the eye and can cause
vision loss.
A person with HIV/AIDS should have regular eye
examinations, because early diagnosis can prevent
serious vision loss

2. HIV/AIDS AND THE EYE
b) Which symptoms or signs should you tell
them about, so that they know to seek help
immediately?
If a person notices :
• Floating spots, flashing lights, blond spots or blurred
vision
• Any grayish white or orangy pink growth on the white
of the eye
• An eye that is red or painful

3. HIV/AIDS AND THE EYE
c) Which are common eye problems in people
with HIV/AIDS that will NOT cause harm
Problems inside the eye:
Cotton wool spots
Problems on the outside of the eye:
 Kaposi's sacroma quite a dark bump, with a lot of veins
often on the eyelid or sometimes a purple red spot on
the white part of the eye (conjunctiva)
 Molluscum contagiousum
 Herpes simplex

4. HIV/AIDS AND THE EYE
d) Which are common eye problems in people
with HIV/AIDS that WILL cause harm, so should
be referred immediately?
Problems inside the eye :
CMV (cytomegelovirus)
Problems on the outside of the eye :
Squamous cell carcinoma is a grayish white growth on the
white part of the eye, closest to the nose (nasal
conjunctiva). It will grow larger so needs to be removed by
surgery as soon as possible

5. HIV/AIDS AND THE EYE
“Shingles” (herpes zoster ophthalmicus)
affects all areas of the eye and around the
eye. It should be identified early and referred
immediately. It can cause :
 Infection of the eyelids (blepharitis)
 Conjunctivitis
 Sclera to be affected
 Corneal problems
 Mild iritis (glaucoma and cataract)
 Retina problems

6. Cotton-wool spots
Cotton-wool spots are:
 White
 Fluffy
Present:
 At the posterior pole
 Located superficially in the retina
 Along vascular arcades
Occasionally:
 Flame shaped haemorrages
 Microaneurysms are present as well

7. Cotton-wool spots
Represent:
Focal areas of ischemia in the nerve fiber layer
Resolve:
In 4-6 weeks but new lesions may develop as pld lesions
resolve

8. Kaposi's sarcoma
Kaposi's sarcoma in an HIV/AIDS patients tends to be:
 Filminant
 Multifocal condition
Develops on the:
 Skin
 Mucous membranes
 Within visceral organs
Conjunctival involvement manifested by red
subconjunctival masses

9. Kaposi's sarcoma
Lesions on the skin as:
 Elevated
 Nontender
 Purplish nodules
Treatment:
 Surgical excision
 Chemotherapy
 Cryotherapy
 Radotherapy

10. Molluscum contagiosum
Caused by:
 DNA virus of the poxvirus family
Spread:
 By direct contact with infected individuals
 By fomites
Clinical presentation:
 Smooth
 Small elevated
 Pearly
 Umblicated nodules

11. Molluscum contagiosum
Associated:
 Chronic follicular conjunctivitis
 Punctate epithelial erosions – on the cornea
 Superficial vascular pannus on the cornea
 Keratoconjunctivitis
In AIDS patient:
 Bilateral
 Humerous
Treatment:
 Excision of nodules
 Freezing the lesions
 Squeezing with following coapulation

12. Herpes simplex virus
Caused by DNA virus
Manifests as:
 Unilateral blepharokeratoconjunctivitis
 Cutaneous vesicles on the eyelid skin
 Stromal keratitis
 Follicular conjunctivitis

13. Herpes simplex virus
Clinical signs:
 Redness of the eye
 Pain
 Tearing
 Blepharospasm
 Sometimes photophobia
 Poor vision
 Eyelid oedema, redness
 Skin lesions on the eyelid

14. Herpes simplex virus
Treatment:
1. Topical antiviral drops (zovirax, acycloviz)
2. Midriatics (atropin, cyclopentolate)
3. Antibiotics (ciprofloxacine, gentemycine)
4. Systemic antiviral drugs for 1 week to limit corneal
involvement and reduce the risk of recurrences

15. Herpes Zoster ophthalmicus
Caused by varicella (chickenpox) virus
Manifestation:
 Cutaneous vesicles at the side of the tipof the nose
indicate nasocilliary nerve involvement. And
mucocutaneous areas of the head, those body
surfaces innervated by 5th cranial nerve

16. Herpes Zoster ophthalmicus
Clinical signs presentation:
 Severe headache
 Fever
 Malaise
 Keratitis – can lead to vasculorization of the cornes
 Uveitis – can lead to iris atrophy, secondary glaucoma,
cataract, acute retinal necrosis
 Corneal staphylloma – thinning of the cornea and
sloughing out may lead to corneal perforation
 Eyelid vesicular eruption can lead to secondary bacterial
infection, scarring, trichiasis, entropion

17. Herpes Zoster ophthalmicus
Treatment:
1. Systemic antiviral drugs
2. Topical antiviral drops and ointment
3. Midriatics
4. Antibiotics
( 1 and 2 to prevent secondary bacterial infection )

18. Cytomegalovirus ( CMV )
Manifests as:
 Full – thickness retinal opacification
 Hard exudate
 Haemorrages
 Periphlebitis
 Retinal necrosis
 Cotton-wool spots
 Vascular distribution
 Large necrotic areas
 Smaller perivascular infiltrates

19. Cytomegalovirus ( CMV )
Lesions may double or triple in dimension within a month.
Areas of retinal and pigment epithelial necrosis resolve,
large areas of atrophy appear. CMV optic neuritis may
develop and cause decrease in V.A.
Development of CMV retinitis in an HIV/AIDS patient is a
poor prognostic sign. Many patients die within months of
the onset of their ocular disease.

20. Squamous cell carcinoma
Manifestation:
Appears as sessile or papillary growth in the interpalpebral area of the
perilimbal conjunctive extension into the eye and metastasis are
frequent.
Arising from conjenctiva as a small white growth, composed pigment
cells and blood vessels encroach to the growth.
Metastasis:
 Preauricular
 Submandibular
 Sinuses - can lead to bone destruction
 Brain

21. Squamous cell carcinoma
Treatment:
In the beginning – excision and biopsy, then
 Exenteration – removal eyeball with eyelids up to
periosteum, include periosteum
 Following the operation chemotherapy and radiotherapy.