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CMV Retinitis

CMV or cytomegalovirus retinitis is a vision threatening virus that causes inflammation of the retina, primarily in individuals with a compromised immune system, such as those with AIDS (Acquired Immunodeficiency Syndrome).

Symptoms of CMV Retinitis

Symptoms of CMV retinitis often appear relatively suddenly. They include general blurriness, seeing flashes or floaters, sudden loss of peripheral (side) vision, or blind spots in central vision. These symptoms all appear as the virus attacks the retina, the light-sensitive layer of nerves at the back of the eye. If left untreated, the virus can cause retinal detachment and will eventually destroy the retina and damage the optic nerve, causing permanent vision loss. Usually there is no pain felt as the retinal damage is taking place. Symptoms usually start in one eye and but can spread to the other eye as well.

Causes of CMV Retinitis

Cytomegalovirus is a herpes type virus that is actually present in most adults. However, most healthy adults never experience any symptoms or problems from the virus. Individuals with a weakened immune system however, such as those with AIDS, chemotherapy or leukemia patients, newborns or the elderly are at greater risk of the virus being activated and spreading throughout the body, including the retina.

Treatment for CMV Retinitis

Treatment includes antiviral medications such as ganciclovir, foscarnet or cidofovir, which can be administered orally, via injection through a vein or directly into the eye or through a time-release implant the releases the medication at intervals. Laser surgery to improve the damaged area of the retina, such as in a retinal detachment, may also be prescribed.

Immune strengthening is also a critical part of preventing and treating CMV retinitis. Individuals with HIV or AIDS may be put on a regimen of highly active antiretroviral therapy (HAART) to boost the immune system and fight the virus. This has been shown to be highly effective in reducing the incidence of CMV retinitis in AIDS patients and reducing the damage for those that are affected.

While these treatments can stop further damage to the retina, any vision that is lost cannot be restored. Further, even if the virus is temporarily stopped, further progression may occur in the future. This is why it is critical to see a retinal specialist on a regular basis if you have had the condition or you are at risk.

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Most people between the ages of 40-45 start to have difficulty seeing up close. This is called Presbyopia and slowly progresses until about the age of 65. This is a normal change due to the lens in the eye hardening and losing flexibility.

Vuity is 1.25% pilocarpine. This is not a new drug. It has been on the market for decades and is used to temporarily shrink the pupil size. It is now being rebranded as a drop that can help improve near vision. How does this work? By shrinking the pupil size, physics tells us this can increase our depth of focus. This drop will not CURE presbyopia. It can improve it while the drop is active and the near blur will return when the dose wears off after approximately 4-6 hours. This drop is recommended for individuals ages 40-55.

Dosage: one drop in each eye once per day. Side effects: possible brown ache or a mild headache. The cost at this time is about $80-90 per month at most pharmacies and insurance does not apply.