Ocular Diseases in HIV-positive Patients in a Tertiary Hospital in Nigeria

Main Article Content

Modupe O. Arowolo
Elizabeth A. Awoyesuku
Chinyere N. Pedro-Egbe


Aims: To determine the pattern of ocular disorders in HIV-positive patients in a tertiary ospital in Nigeria.

Study Design: A cross-sectional hospital based study on confirmed HIV positive adult patients attending the HIV clinic in University of Port Harcourt Teaching Hospital.

Duration of Study:  November and December 2011.

Methodology: Consecutive patients within the inclusion criteria were recruited until the required sample size was met. The visual acuity was tested using the Snellen’s chart and the illiterate E-chart. Ocular examination of the adnexial and anterior segments were done using a pen torch and a slit lamp biomicroscope. Fundoscopy was done using a direct and indirect ophthalmoscope as well as with a 90D lens. Other information such as CD4 count and HIV serotype were retrieved from the patient’s case notes. The data was analysed using EPI-info version 7.0. Statistical methods such as the frequency and chi-square were used to test the significance of association. Level of significance was drawn at P<0.05.

Results: A total of 411 patients were enrolled in this study. The age range was between 18-69 years with a mean age of 36.9 years. There was a female preponderance with a male to female ratio of 1:2. Ocular disorders were seen in 37.1% of patients studied. The commonest manifestation was the ocular adnexial manifestation and conjunctival microvasculopathy ranked highest (15.6%) in this group. Herpes zoster ophthalmicus was seen in 5 (1.2%) patients, presumed squamous cell carcinoma in 12(2.9%) and Kaposi sarcoma in 3(0.7%). Chorioretinitis was found in 12(2.9%), retinal microvasculopathy in 19(4.6%) and maculopathy in 15(3.6%). There was no case of CMV retinitis.

Conclusion: Ocular findings seen in HIV- positive patients were mostly adnexial and occurred in 37% of the study population.

Ocular findings, HIV-positive, tertiary hospital.

Article Details

How to Cite
O. Arowolo, M., Awoyesuku, E. A., & Pedro-Egbe, C. N. (2019). Ocular Diseases in HIV-positive Patients in a Tertiary Hospital in Nigeria. International Journal of TROPICAL DISEASE & Health, 39(3), 1-9. https://doi.org/10.9734/ijtdh/2019/v39i330207
Original Research Article


Hymes KB, Griene JB, Marcus E. Kaposi sarcoma in homosexual men: A report of eight cases. Lancet. 1981;2.

Pneumocystis pneumonia Los Angeles: MMR weekly. 1981;1-3.

World Health Organization: UNAIDS/WHO report on the global HIV/AIDS epidemic, Geneva; 2018.

UNAIDS Overview Nigeria; 2018.

Holland GN. AIDS and Ophthalmology: the first quarter century. AMJ Ophthalmo. 2008;145:397-408.

Cunningham ET, Margolis TP. Ocular manifestations of HIV infection. N Engl J. Med. 1998;339:236-244.

Kestelyn PG, Cunningham E. HIV/AIDS and blindness. Bull World Health Organisation. 2001;79:208-213.

Feroze KB, Wang J. Ocular manifestations of HIV [updated 2019 Jan 13]. In: Star Pearls [Internet]. Treasure Island (FL): StarPearls Publishing.

Biswas J, Kumaraswamy N, Solomon S. Ophthalmic manifestations of human immunodeficiency virus in India. Indian J Ophthalmol. 1999;47:87-93.

Gogri PY, Misra SL, Kothari RN, Bhandari AJ, Gidwani HY. Ophthalmic manifestations of HIV Patients in a rural area of Western Maharashtra, India. International Scholarly Research Notices 2014.
[Article ID: 347638]

Biswas J. Acquired immunodeficiency Syndrome and the eye. J Assoc. Physicians India. 2001;49:551-557.

Behele S, Gelaw Y, Tessema F. Ocular manifestation of HIV/AIDS and correlation with CD4+ cells count among adults HIV/AIDS patients in Jimma town, Ethiopia: A cross sectional study. BMC Ophthalmology. 2013;13:20.
DOI: 10.1186/1471-2415-13-20

Gooding K. Poverty and blindness: A survey of literature. 1st ed. Hayward’s Health (UK): Sight Savers international; 2006.

Pathai S, Deshpande A, Gilbert C, Lawn SD. Prevalence of HIV- associated ophthalmic disease among patients enrolling for antiretroviral treatment in India. BMC Infect Disease. 2009;9:158.

Lewallen S, Courtright P. HIV/AIDS and the eye in developing countries: A review. Arch Ophthalmol. 1997;115:1291-1295.

Muccioli C, Belfort R, Lottenberg C, Lima J, Santos P, et al. Ophthalmological manifestations in AIDS: Evaluation of 445 patients in one year. Revista da Associacoo Medical Brasillide. 1994;40:155-158.

Arruda RF, Mucciolo C, Belfort R Jr. Ophthalmologic findings in HIV infected patients in the post-HAART era compared to pre-HAART era. Rev. Assoc. Med Bras. 2004;50:148-152.

Gharai S, Venkatesh P, Garg S, Sharma SK, Vohra R. Ophthalmic manifestations of HIV infection in India in the era of HAART. Ophthalmic Epidemic. 2008;15:264-271.

Lai TY, Wong RL, Luk FO, Chow VW, Chan CK, Lam DS. Ophthalmic manifestations and risk factors for mortality of HIV patients in the post–highly active antiretroviral therapy era. Clin. Experiment Ophthalmol. 2011;39(2):99-104.

Otiti-sengeri J, Robert MD, Kempen JH, Ronald A, Sande M. The prevalence and causes of visual loss among HIV infected individuals in Uganda. Journal of Acquired Immune Deficiency Syndrome. 2010;53(1): 95-101.

Nwosu NN. HIV/AIDS in ophthalmic patients: The Guinness eye center Onitsha experience. Niger Post Grad Med J. 2008;15:24-27.

Adio AO, Fiebai B. Herpes zoster ophthalmicus and HIV seropositivity in South –South Nigeria. Niger J. Med. 2010;19:162-164.

Adepoju FG, Olawumi HO, Adekoya BJ. HIV seropositivity and related eye disease in UITH, Ilorin. Niger Post Grad Med J. 2007;14:163-165.

Osahon AI, Onunu AN. Ocular disorders in patients infected with human immunodeficiency virus at the University of Benin Teaching Hospital, Benin City, Nigeria. Niger. J. Clini Pract. 2007;01:283-286.

Umeh RE. Herpes Zoster ophthalmicus and HIV infection in Nigeria. Int. J. STD. AIDS. 1998;9(8):476-479.

Omolase CO, Komolafe OO, Ayodeji OO. Ocular manifestations in HIV-AIDS patients in a Nigerian community. A Afr Fam P. 2012;34(5):455-458.

Onakoya AO, Odeyemi MG, Aribaba OT, Akinsola FB. Ocular findings in acquired immunodeficiency syndrome patients in Lagos, Nigeria. Nig Q J Hosp Med. 2012;22(1):52-57.

Entonu PE, Agwale SM. A review of the epidemiology, prevention and treatment of human immunodeficiency virus infection in Nigeria. Braz J Infect.

Onunkwor CI. Ophthalmic manifestation in HIV/AIDS patients receiving antiretroviral therapy. A dissertation submitted to National Postgraduate Medical College for the award of FMC Ophth; 2007.

Martin-Odoom A, Bonney EY, Opoku DK. Ocular complications in HIV positive patients on antiretroviral therapy in Ghana. BMC Ophthalmology. 2016;16: 134.

Ebana Mvogo C, Ellong A, Bella AL, Luma H, Achu Joko H. Ocular complications of HIV/AIDS in Cameroon: Is there any correlation with the level of CD4 lymphocytes count? Bull Soc Belge Ophthalmol. 2007;305:7-12.

Ndoye NB, Sow PS. Ocular manifestations of AIDS in Dakar. Dakar Med (Senegal). 1993;38:97-100.

Odeyemi B. Ocular disorders in HIV/AIDS patients attending PEPFAR clinic at the Lagos University Teaching Hospital, Nigeria. A dissertation submitted to National Postgraduate College for the award of FMC Ophth; 2009.