“No recovery of vision” in Royal Bolton Hospital patient with undiagnosed HIV

A retired woman who lost her sight after living with ophthalmic shingles for more than two years has been diagnosed with HIV.

Writing in BMJ Case Reports, clinicians from Royal Bolton Hospital describe how the patient presented with acute retinal necrosis in her right eye and a fibrotic retinal detachment in her left eye.

The patient tested positive for the varicella zoster virus and HIV.

Antiretroviral medications were prescribed, but there was no recovery of vision.

“This case highlights the importance of suspecting HIV in patients with severe or chronic ophthalmic shingles,” the authors emphasised.

They also highlight that progressive outer retinal necrosis may be a presenting sign of a previously unrecognised HIV infection.

Clinicians believe that the woman, who was unaware she was HIV positive, had been living with the condition for more than five years.

Image credit: BMJ Case Reports 2018