Zika and Your Eyes

Written by Aly R. Sheraly, M.D.
Board Certified Ophthalmologist 

A Look At the Zika Virus’ Effect On the Eyes.

This year has seen the introduction and spread of the Zika virus across much of the Americas. Many parts of the USA have been affected with imported cases, but specific focus is on states like Florida and territories like Puerto Rico where active mosquito spread is occurring in the communities. It is known that the Zika virus can affect people of all ages, but particular attention has been on pregnant women as the virus can cause birth defects such as microcephaly. Much is still unknown about this virus and much of what we do know is constantly being updated as new research is presented. The CDC has been active in keeping the public and medical community informed about this outbreak and ways to reduce your risk of acquiring the virus. For the latest information, please visit:   http://bit.ly/2fxzlKf

The focus of this article is to present some of the new data that is available regarding the effects of the Zika virus on the eyes. While the association between the birth defects of microcephaly and the virus is well publicized, the effects on the eyes are less known, and currently research is being undertaken to document these effects. It is important to understand that not every infection will lead to symptoms or developmental defects and, more importantly, the cause-effect relationships are still being actively investigated. Currently, the noted effects of the Zika virus can be divided into two categories: congenital and non-congenital. The first category, congenital defects, are those effects that occur while infection was acquired by the baby while developing in the womb. The second category, non-congenital, are those effects on children and adults, meaning infection that occurs outside the womb.

Congenital Defects

Firstly, it is important to note that very little is definitively known at this point and all evidence is obtained from cases as they are reported in the medical literature. Furthermore, the cause-effect relationships are not clearly established and there may be many other factors at play that influence the outcome of congenital birth defects.  Currently, there have been several reports of newborns who were born with microcephaly who also have eye abnormalities in their retina, choroid and optic nerve. The retina and optic nerve are responsible for capturing and transmitting images to the brain. It is unclear if these eye abnormalities or the neurological/brain abnormalities are the primary source of vision loss in these newborns. Just recently, screening studies of newborns infected with the Zika virus born without microcephaly demonstrated some retinal abnormalities, indicating that developmental abnormalities in the eye can occur separately from the brain. It is unclear if these changes have significant impact on the vision potential of these newborns. However, it does emphasize the need for screening and close monitoring of Zika-infected newborns. The current CDC recommendation for newborns infected with the Zika virus is to be screened for any eye abnormalities by an ophthalmologist no later than one month after birth. Refer to the CDC or your pediatric doctor for the most current recommendations regarding general Zika screening practices and protocols.

Non-Congenital Effects

Children and adults can be infected by the Zika virus after birth in several different ways.  Most do not experience any symptoms. However, those that do may experience flu-like symptoms.  The most common eye symptom is conjunctivitis, commonly referred to as “pink eye”. Patients can experience itchy, watery, red eyes, which usually resolves on its own. While it is not clear if the Zika virus is actively spread when a patient has conjunctivitis, it is important to take proper hygiene protocols, namely frequent hand washing with soap and water. There are a few case reports in the literature regarding adults who developed inflammation in the eyes. These cases resolved without treatment as well.

Take Home Message

It is important to stay informed and take the common sense precautions as outlined by the CDC to protect you, your family and your neighbors. Remember to remove any standing water from your property as they can serve as breeding sites for mosquitoes that carry the virus. Remember to cover exposed skin during the day by wearing long sleeves, pants, socks and shoes and apply mosquito repellent.

At Eye Specialists of Mid-Florida we strive to serve our community with the latest medical and clinical knowledge as well as providing patients with state of the art equipment to serve all your eye care needs. Book your appointment with us today or visit our website at:   http://bit.ly/EyesFL


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