Retinitis
What is Retinitis?
Retinitis is inflammation of the retina, the light-sensitive tissue at the back of your eye. The retina captures images and sends signals to your brain so you can see. When the retina becomes inflamed or infected, it can damage these delicate cells and affect your vision.
This condition often results from viral infections, especially in people with weakened immune systems. Cytomegalovirus, or CMV, is one of the most common causes of infectious retinitis. Without treatment, retinitis can cause permanent vision loss or blindness. Early detection and treatment are essential to protect your sight.
Retinitis is different from retinopathy, which refers to damage from conditions like diabetes or high blood pressure. Retinitis specifically involves inflammation or infection of the retinal tissue. It requires prompt medical attention from an eye specialist and often an infectious disease doctor.
Symptoms
- Blurry or cloudy vision in one or both eyes
- Floaters, small spots or lines that drift across your field of vision
- Flashes of light in your peripheral vision
- Blind spots or dark areas in your visual field
- Loss of peripheral vision, seeing through a tunnel
- Difficulty seeing at night or in low light
- Rapid or progressive vision loss
- Eye pain or redness in some cases
Some people may not notice symptoms until the condition has progressed significantly. The infection can start at the outer edges of your retina where changes are harder to detect. Regular eye exams are important, especially if you have a weakened immune system.
Concerned about Retinitis? Check your levels.
Screen for 1,200+ health conditions
Causes and risk factors
Retinitis is most commonly caused by viral infections, particularly cytomegalovirus or CMV. CMV retinitis occurs almost exclusively in people with severely weakened immune systems, such as those with HIV/AIDS, organ transplant recipients, or patients on immune-suppressing medications. Other viral causes include herpes simplex virus, varicella zoster virus, and toxoplasmosis. These infections take advantage of a compromised immune system to infect the retina.
Your risk increases if you have HIV with a CD4 count below 50 cells per microliter, have received an organ transplant, are taking chemotherapy or immunosuppressive drugs, or have an autoimmune disease requiring immune suppression. People with well-controlled HIV who take antiretroviral therapy have much lower risk. Newborns can develop retinitis if their mother passes certain infections during pregnancy or birth. Maintaining a healthy immune system through proper medical care reduces your risk significantly.
How it's diagnosed
Diagnosis starts with a dilated eye exam by an ophthalmologist, an eye doctor who specializes in medical and surgical eye care. Your doctor will use special instruments to look at your retina and check for signs of inflammation, lesions, or bleeding. They may take photos of your retina to document the condition and track changes over time.
Blood tests help identify the underlying infection causing retinitis. Testing for cytomegalovirus antibodies can show if you have been exposed to CMV, a common cause of infectious retinitis in people with weakened immune systems. Your doctor may also order tests to check your immune function and identify other possible infections. Talk to your doctor about specialized testing for retinitis. Some tests require imaging studies or samples of eye fluid to confirm the diagnosis and determine the best treatment approach.
Treatment options
- Antiviral medications given as pills, eye injections, or intravenous infusions to fight the infection
- Immune system support through antiretroviral therapy for HIV patients or adjusting immunosuppressive medications
- Regular eye exams to monitor the retina and catch progression early
- Valganciclovir or ganciclovir specifically for CMV retinitis
- Foscarnet or cidofovir for resistant infections or when other medications cause side effects
- Intravitreal injections, medication delivered directly into the eye for severe cases
- Surgical repair if retinal detachment occurs as a complication
- Working closely with both an ophthalmologist and infectious disease specialist
- Long-term maintenance therapy to prevent recurrence once the infection is controlled
Frequently asked questions
Cytomegalovirus or CMV is the most common cause of infectious retinitis, especially in people with weakened immune systems. CMV retinitis primarily affects people with HIV/AIDS who have very low CD4 counts, organ transplant recipients, and patients taking immunosuppressive medications. Other causes include herpes viruses and toxoplasmosis infections.
Yes, retinitis can cause permanent vision loss or blindness if not treated promptly. The infection damages the light-sensitive cells in your retina, and this damage cannot be reversed. However, early treatment with antiviral medications can stop the infection from progressing and preserve your remaining vision. This is why immediate medical attention is critical when symptoms appear.
Retinitis can progress rapidly, sometimes over days to weeks, depending on the cause and your immune function. CMV retinitis typically progresses over 2 to 4 weeks without treatment. The infection spreads across the retina and can cause retinal detachment. Quick diagnosis and treatment are essential to prevent irreversible vision loss.
People with severely compromised immune systems are at highest risk. This includes HIV/AIDS patients with CD4 counts below 50 cells per microliter, organ transplant recipients on anti-rejection drugs, chemotherapy patients, and people with autoimmune diseases taking immunosuppressants. People with well-managed HIV on antiretroviral therapy have much lower risk. Newborns can also develop retinitis from congenital infections passed from mother to child.
Blood tests for cytomegalovirus antibodies can show if you have been exposed to CMV, a leading cause of infectious retinitis. Your doctor may also order tests to check your immune function, including CD4 count if you have HIV. Additional blood tests may look for other infections like herpes viruses or toxoplasmosis. These tests help identify the underlying cause so your doctor can prescribe the right treatment.
Retinitis itself is not contagious, but the viruses that cause it can spread from person to person. CMV spreads through body fluids like saliva, urine, blood, and breast milk. However, most people with healthy immune systems who get infected with CMV never develop retinitis. The condition primarily affects those with weakened immunity who cannot control the viral infection.
Yes, taking antiretroviral therapy consistently to maintain a healthy CD4 count is the best prevention. When your CD4 count stays above 100 cells per microliter, your risk of CMV retinitis drops significantly. Your doctor may also prescribe preventive antiviral medication if your CD4 count falls very low. Regular eye exams help catch any problems early before significant vision loss occurs.
Retinitis is inflammation or infection of the retina, usually caused by viruses in people with weakened immune systems. Retinopathy refers to retinal damage from other conditions like diabetes, high blood pressure, or blocked blood vessels. While both affect the retina and can cause vision loss, they have different causes and treatments. Retinitis requires antiviral medications, while retinopathy focuses on managing the underlying disease.
During active infection, you may need eye exams every 1 to 2 weeks to monitor treatment response and check for progression. Once the infection is controlled, you will need regular monitoring every 1 to 3 months, depending on your immune status. Your ophthalmologist will take retinal photos at each visit to track any changes. Lifelong monitoring is often necessary for people with ongoing immune suppression.
Yes, retinitis can recur, especially if your immune system remains weak. Many patients require long-term maintenance therapy with antiviral medications to prevent recurrence. If you stop treatment too soon or your immune function worsens, the infection can reactivate. This is why ongoing monitoring and continuing your prescribed medications are essential, even after the initial infection is controlled.