What is AIDS?

AIDS stands for Acquired Immunodeficiency Syndrome. It is a disease of the body's immune system. In a healthy individual, the immune system helps to fight off illness such as an infection.

What is HIV?

AIDS is caused by a virus called the Human Immnodeficiency Virus (HIV), which attacks many cells in the body. HIV especially attacks white blood cells called lymphocytes. One special kind of lymphocyte is known as the T-cell.

You can be infected with HIV but not get sick with AIDS until many years later. You are considered to have AIDS when:

* Your T-cells drop below a certain level (under 200 T-cells per cubic millimeter) in a blood test;

* Your immune system is no longer able to keep you healthy.

It's very important to know if you are HIV positive at an early stage. If you get treatment before you are sick, you can stay well longer.

How Can You Catch HIV and AIDS?

Anyone can catch H IV. It can be spread by:

* Having sex with an infected person;

* Sharing hypodermic needles;

* Being born to a mother who has HIV;

* Receiving transfusions with infected blood.

Blood banks in the United States now test blood for HIV. It is very rare to get AIDS from blood transfusions.

What about HIV in tears?

While the HIV virus can be found in tears of people with AIDS, no cases of AIDS have ever been reported from tear contact. Ophthalmologists are especially careful in cleaning their lenses and instruments which come in contact with tears.

How does AIDS affect the eye?

Cotton Wool Spots-The most common eye problem from AIDS doesn't threaten vision. Your eye has an inner layer called the retina, which sends images to the brain and helps us see. AIDS can cause white spots in the retina sometimes with tiny amounts of bleeding. These white spots are called "cotton wool spots" because they look like small cotton balls.

CMV Retinitis-A serious eye infection of the retina is caused by CMV, the cytomegalovirus (CMV). About 20-30% of people with AIDS develop CMV. Most infections happen when the number of T-cells gets dangerously low.

Early diagnosis is important. The earlier your ophthalmologist finds CMV, the better the odds your vision can be helped. CMV can harm your vision permanently. Call an ophthalmologist right away if you see:

* Floating spots or "spiderwebs";

* Flashing lights;

* Blind spots or blurred vision.

If you have HIV, you should have a baseline examination by an ophthalmologist. Regular screening examinations, perhaps as often as every 3-6 months, may be recommended if your T-cell count becomes low. These issues should be discussed with your ophthalmologist and your internist.

Detached retina-Sometimes CMV causes the retina to separate from the back of the eye. A detached retina can cause serious vision loss. The only way to re-attach the retina is to have eye surgery.

Kaposi's sarcoma-Kaposi's sarcoma (KS) is a kind of tumor that looks like purple-red spots. In the eyes, it can look like a bump on the eyelid or a spot on the white part of the eye. KS can look frightening, but it grows slowly and does not harm the eye.

What are the treatments for AIDS eye problems?

Drugs, such as Ganciclovirt' (DHPG) and Foscarnet(F>, are commonly used to fight CMV infections. Such drugs don't kill CMV but slows its progression. You must go to your ophthalmologist for regular eye exams while being treated for CMV to be sure the CMV infection is responding to the medicine. If only one eye is infected, you may be able to protect the other eye by taking anti-CMV medicines. New treatments are continuously being developed. If necessary, Kaposi's sarcoma (KS) can be treated with radiation, laser surgery, freezing, or conventional surgery.

There are other eye infections with AIDS. The symptoms may be the same as CMV: floaters, flashes or blind spots. But each disease has its own treatment and only your ophthalmologist can tell which you need.

Regular eye exams are important in HIV infection.

If your T-cell count is very low, it is more likely that you will get a serious eye infection. If you experience changes in your vision, you need to see your ophthalmologist promptly.