Visual problems

Blurred or partial loss of vision is a symptom which many people with HIV infection are very apprehensive of. Floaters in the vision are an important early warning of visual problems.

CMV infection with the resulting damage to the retina (retinitis) is the most common cause but other opportunistic infections of the eye include toxoplasmosis, Cryptococcus and Candida. These usually only occur in persons with symptomatic HIV disease who have very low CD4 counts.

Cotton wool spots in the field of vision or HIV retinopathy are also common and usually resolve spontaneously.

Infections in the visual part of the brain may interfere with or destroy sight: this is called cortical blindness.

If visual symptoms develop urgent and prompt consultation with a doctor is needed. There may then be a referral to a medical ophthalmologist if appropriate. Treatment of CMV retinitis can halt and prevent further visual loss, but not reverse it; maintenance therapy is necessary to reduce the risk of further visual loss.

Practical difficulties of coping with visual impairment may be multiple and include everyday activities such as cooking, bathing, taking medication, shopping and driving. Help is available from occupational therapists, local social services and specialist HIV/AIDS voluntary services. Adjusting to visual impairment can cause marked emotional problems and help from counselling services may be needed.