Ophthalmic problems

Howard F. Fine; Susan S. Lee; Michael R. Robinson

doi:10.1017/CBO9780511544798.030

27 - Ophthalmic problems

from Part IV - Clinical manifestations of HIV infection in children

Published online by Cambridge University Press: 03 February 2010

Howard F. Fine ,

Susan S. Lee and

Michael R. Robinson

Edited by

Steven L. Zeichner and

Jennifer S. Read

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Howard F. Fine: Affiliation:
Ophthalmology, Wilmer Eye Institute, Johns Hopkins, Baltimore, MD
Susan S. Lee: Affiliation:
National Eye Institute, NIH, Bethesda, MD
Michael R. Robinson: Affiliation:
National Eye Institute, NIH, Bethesda, MD
Steven L. Zeichner: Affiliation:
National Cancer Institute, Bethesda, Maryland
Jennifer S. Read: Affiliation:
National Cancer Institute, Bethesda, Maryland

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Summary

Introduction

Ophthalmic disease is common in patients with HIV infection, occurring in up to 75% of patients over the course of their illness [1]. As in other organ systems, a hallmark of the ocular sequelae of HIV infection is the presence of opportunistic infections by bacteria, viruses, fungi, and parasites, which may occur in up to 30% of HIV-positive individuals [2, 3]. HIV-positive children may acquire infections that are also common in immunocompetent patients, although the severity is often greatly increased.

Because children rarely complain of ocular symptoms, eye disease such as cytomegalovirus (CMV) retinitis, is often diagnosed at a more advanced stage. This chapter gives an overview of the ocular manifestations of HIV in children.

Epidemiology

Ophthalmologic disease in HIV-infected children can involve any part of the eye. The ocular manifestations of HIV infection in children are listed in Table 27.1; few of the disorders occur in more than 5% of children. The most common ophthalmologic disease in HIV-infected children affects the posterior segment (vitreous, retina, and choroid).

Clinical examination

Routine screening eye examinations are suggested because sight-threatening complications like CMV retinitis can be asymptomatic, and early diagnosis and treatment can prevent loss of sight. Sight-threatening diseases occur most frequently in children with advanced HIV infection and low CD4+ lymphocyte counts. Regular screening examinations should be performed by an experienced ophthalmologist according to Table 27.2 [4].

Type: Chapter
Information: Textbook of Pediatric HIV Care , pp. 445 - 454

DOI: https://doi.org/10.1017/CBO9780511544798.030 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2005

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