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What you need to know about Zika Virus and the Eye

The Zika Virus

The Zika virus is a flavivirus transmitted by Aedes mosquitoes. It is related to the Dengue and West Nile virus. First identified in Uganda and French Polynesia, page it has spread to Brazil, and been associated with an epidemic of foetal abnormalities especially microcephaly (abnormally small head-to-brain structure). It has now been identified in Singapore. The primary infection is usually mild, most commonly with fever, non-specific rash and joint pains. It may even be asymptomatic.

Eye problems in Babies with Zika Infection

Together with the foetal changes, eye problems have also been diagnosed typically when the infection occurs in the 1st or 2nd trimester of pregnancy. Eye abnormalities were seen in about 1/3 of babies with microcephaly and usually affected both eyes. The main findings were pigmentary changes to the retina with defined areas of degeneration of the choroid (the layer of vessels that provides oxygen and nutrition to the retina). Other findings include bleeding, optic nerve abnormalities, retinal blood vessel abnormalities and changes to the central retina (torpedo maculopathy) that may eventually affect central and peripheral vision. Reports of iris defects (coloboma) and lens dislocation have been described but still as yet cannot be completely attributable to the Zika virus.

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Eye problems in Adults

The Zika virus can also affect adults. The most common finding is a mild non-purulent conjunctivitis (red eye). However a more serious form of intraocular inflammation (uveitis) can also occur, that can mimic a painful red eye. Left untreated, uveitis can result in cataract, high eye pressure (glaucoma) and in severe cases, retinal swelling and blindness.

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Notes

Doctors should be aware that babies should be referred for eye examinations if they have abnormal head structures (microcephaly) that can be possibly attributed to the Zika virus. Likewise, adults with Zika virus infection and red eyes should be referred for an examination if the condition does not resolve or worsens after a few days.

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Article by:

Dr Stephen Teoh

eec-drlim

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