HIV retinopathy is a common HIV-related eye condition. It can cause visual impairments or vision loss.

HIV-related eye disease affects 50–75% of people living with HIV worldwide. HIV retinopathy, in particular, is the most common eye disease among people living with HIV.

It’s characterized by damage to the retina, the light-sensitive tissue at the back of the eye responsible for processing visual information.

With HIV retinopathy, the blood vessels in the retina may bleed or become blocked. This can, in some cases, cause visual impairments and potential loss of vision.

HIV treatments can help prevent the development of HIV retinopathy and other complications.

HIV-related retinopathy may not cause symptoms at first. Symptoms can also vary from person to person. It all depends on how the retina is damaged.

You might experience one or more of the following:

In advanced cases, HIV retinopathy can lead to partial or total vision loss. In some cases, early treatment can prevent vision loss.

HIV retinopathy may be caused by:

  • Microvasculopathy: This is a disease where small blood vessels in the retina are damaged. They may be damaged by HIV infecting the vessel lining, a buildup of HIV-infected cells, or increased plasma viscosity.
  • Infections: HIV can weaken the immune system, leading to opportunistic infections in the retina. A common retina infection is cytomegalovirus (CMV) retinitis.
  • Tumors: Tumors can affect the eye, including the retina. People living with HIV may be more susceptible to certain tumors, such as Kaposi sarcoma.

It’s possible to experience more than one of the above conditions at the same time.

An eye specialist called an ophthalmologist can diagnose HIV retinopathy with a comprehensive eye exam.

Your clinician will likely start by asking about your medical history. They may also ask you to describe any concerning vision- or eye-related symptoms.

Your clinician may use the following eye exams to test for HIV-related retinopathy and other eye-related conditions:

  • visual acuity exam, which tests your eyesight
  • dilated eye exam, which involves using eye drops to widen your pupils so the doctor can examine the inside of your eyes
  • fluorescein angiography, where dye is injected into a vein (often in your arm) and travels to your retina, and then photographs are taken to assess the retina
  • optical coherence tomography (OCT), which is a noninvasive imaging test that takes cross-sectional images of the retina to help clinicians assess the retina
  • silt lamp exam, where eye drops with a dye may be placed in your eyes before pictures are taken of your retina
  • blood tests, which can look for signs of CMV and other opportunistic viruses

Your eye doctor may also order blood tests to check your CD4 count. A low CD4 count is associated with a higher risk of HIV-related retinopathy.

Regular visual exams may be beneficial if you’re living with HIV. Your clinician can recommend a screening schedule best suited to your individual needs.

The treatment of HIV retinopathy depends on the cause of the damage. There are no treatments for HIV miсrоvаѕсulораthу, but there are a few possible treatments for CMV retinitis.

Antiviral medications can treat HIV-related CMV retinitis, such as:

  • сidоfоvir
  • foscarnet (Foscavir)
  • gаnсiсlоvir
  • vаlgаnсiсlоvir

If you have a tumor in your eye, radiation treatment or surgery could be used to shrink or remove it.

If you haven’t already started HIV treatment, a clinician may prescribe it. The main HIV treatment is antiretroviral therapy (ART), a combination of daily medications that prevent the virus from reproducing further.

ART may prevent further damage to your eye and prevent the overall progression of HIV. It can increase your life expectancy and reduce the risk of transmitting HIV to others.

With HIV retinopathy, it’s possible to lose vision in one or both eyes. HIV miсrоvаѕсulораthу often doesn’t lead to full vision loss, especially if you begin HIV treatment.

Vision loss is more common with CMV retinitis. This infection can cause tissue death or retinal detachment, which can lead to vision loss.

HIV retinopathy may be a sign that your CD4 count is low. CD4 cells are an essential part of your immune system. A low CD4 count can make you vulnerable to other health conditions, including infections.

The sooner you seek help for vision loss, the better. Your overall outlook depends on the type of retinopathy that you’re experiencing.

HIV miсrоvаѕсulораthу rarely leads to total vision loss. CMV retinitis may lead to vision loss if left untreated, but there are a number of effective treatment options available.

HIV retinopathy can be improved if you use antiretrovirals as prescribed. Treatment for HIV can prevent further damage to the retina.

HIV affects the immune system, leading to a range of potential complications. People living with HIV may experience eye conditions like retinopathy, for example. This may, in some cases, lead to vision loss.

General HIV treatments, which include a combination of antiretroviral medications, can help prevent and assist with HIV retinopathy. Other treatments can also improve the symptoms of HIV retinopathy.

If you’re living with HIV and think it’s affecting your vision, consult an eye doctor as soon as possible.

Sian Ferguson is a freelance health and cannabis writer based in Cape Town, South Africa. She’s passionate about empowering readers to take care of their mental and physical health through science-based, empathetically delivered information.