Aging, HIV, and Eye Health

The population of aging HIV patients is growing. On a global scale, 4.2 million people over 50 years old have HIV, with 8 in 10 of them coming from low- and middle-income countries as of 2016. In the United States, over half of HIV-positive Americans who know about their diagnosis were aged 50 and older in 2018.

Today, this global public health issue has claimed at least 40.4 million lives. As for long-term HIV survivors, many of them experience consequential health issues, including HIV-related eye problems. Even singer-songwriter Freddie Mercury, who contracted HIV/AIDS in the 1970s, was nearly blind in his final days, revealed Elton John in his memoir, Me.


How HIV Affects Aging Eyes: Causes and Early Symptoms

Nowadays, fewer HIV survivors develop eye problems thanks to advancing anti-HIV treatments. When they do occur, the causes include:

  • HIV impacting the blood vessels and nerves in the eye
  • Opportunistic infections such as cytomegalovirus
  • Intake of medication to address an opportunistic infection

In addition, you are more likely to develop HIV-related eye problems from:

  • Having a low count of CD4 (white blood cells that fight infection)
  • Not receiving HIV treatment
  • HIV treatment not working properly

Once HIV begins affecting your eyes, these symptoms may arise:

  • Blurriness or double vision
  • Seeing floaters or flashes of light
  • Empty areas in your field of vision
  • Heightened sensitivity to light
  • Eye pain or discomfort
  • Changes in how you perceive colors
  • Any other unusual changes in your vision

The longer you live with HIV without treatments, the more vulnerable you are to HIV-associated eye conditions such as herpetic keratitis, optic neuropathy, infectious retinitis, cataracts, dry eyes, uveitis, and HIV retinopathy. Keep reading to learn more about them.


Common HIV-Related Eye Problems to Look Out for as You Age

Poorly managed HIV infection can lead to the following eye problems:


1. Keratitis

This ocular infection affects the cornea – the clear dome covering the colored portion of your eye. It usually heals without causing damage, but severe infections can scar the cornea or cause blindness. Its symptoms include:

  • Eye redness
  • Eye pain
  • Light sensitivity
  • Blurry vision
  • Watery secretion

Keratitis in HIV-positive individuals is rare, seen in less than 5% of all cases. Treatment typically involves medicated eye drops or pills. Surgical intervention may be necessary if corneal scarring causes vision problems.


2. Optic Neuropathy

HIV-associated optic neuropathy results from the optic nerve sustaining damage, usually due to coinfection with syphilis or cytomegalovirus. The optic nerve is a group of nerve fibers that transmit visual information from the eyes to the brain. When optic neuropathy occurs, it can lead to:

  • Pain when moving the affected eye
  • Blurred vision
  • Reduced color vision
  • Blind spots
  • Complete loss of vision

Prompt initiation of antiretroviral therapy (ART) remains the primary treatment for this ocular manifestation of HIV.


3. Infectious Retinitis

This HIV-associated inflammation damages the retina – a layer of glial cells and photoreceptors that captures light and translates it into the images you see. In its early stages, HIV patients may see floaters and experience low vision. Without treatment (injections into the eye, oral medicine, laser procedures, or surgery), damage to the retina can lead to permanent blindness in four to six months or less.


4. Cataracts and Dry Eyes

The aging HIV population is more likely to develop cataracts and dry eyes. Cataracts manifest as cloudy patches on the eye’s lens, while dry eye syndrome is the inability to release sufficient tears to lubricate the eyes.

If you have a cataract or a case of dry eyes, see your eye doctor in Sun City, AZ, for advice about managing your condition. You might require surgery to address cataracts or prescription drops to ease dry eye symptoms.


5. Uveitis

Uveitis is a rare inflammation within the eye. It occurs when your immune system is fighting an infection, or in this case, HIV. Its symptoms include:

  • Blurry vision
  • Eye pain and redness
  • Sensitivity to light
  • Floaters in your field of vision
  • Low vision

Treatment options for uveitis include prescription eye drops, oral steroids, or injections. If these treatments do not work, placing a small device into your eye via surgery is another option. The implanted device will give regular doses of steroids or corticosteroids, which act like hormones to reduce inflammation. However, these human-made chemicals can have side effects, such as increasing your risk for cataracts and glaucoma. If your doctor suggests taking steroids for uveitis, get regular eye exams to check for signs of these conditions.


6. HIV Retinopathy

HIV retinopathy involves bleeding or blocked blood vessels in the retina. Over time, it can lead to visual disturbances and loss of vision. This condition has no specific treatment, although anti-HIV treatments should help.


How to Prevent or Manage Aging and HIV-Related Eye Problems

You may protect your eyes from HIV-associated ocular conditions with the following:


1. Seek HIV Treatment

While many of the above conditions have dedicated treatment approaches, ultimately, receiving consistent HIV treatment is the best way to prevent and manage HIV-associated eye problems. Most individuals require 7 to 12 months of antiretroviral therapy to achieve an undetectable viral load.


2. Maintain a Healthy Lifestyle

The lifestyle choices that keep you healthy – including engaging in regular exercise, eating fruits and vegetables, moderating alcohol consumption, not smoking, and limiting sun exposure – can help preserve optimal eye health and visual wellness. In addition, remember to practice safe sex to prevent HIV reinfection and superinfection.


3. Get Regular Eye Exams

If your CD4 count is below 50, it’s advisable to schedule an eye examination every three months. As discussed, HIV survivors have a higher risk for eye conditions and vision issues, especially as they age. Regular visits to an eye doctor can monitor, detect, and address problems before they progress.


Screen for HIV Eye Complications Today

Screening for ocular involvement in HIV requires a dilated exam to assess the retina and other parts of the eye. Visit Arizona Retinal Specialists in Sun City for a comprehensive eye exam near you. Your vision and overall health are worth it.

NOTICE TO USERS is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified health provider with any questions you may have regarding any health symptom or medical condition. Never disregard professional medical advice nor delay in seeking professional advice or treatment because of something you have read on