Eye Infections May Lead to Preventable Vision Damage

Researchers say two infectious eye diseases can cause permanent harm to vision if treatment is not started soon enough.

New reviews from Flinders University draw attention to ocular syphilis and ocular toxoplasmosis, two conditions that can resemble other eye disorders and may be overlooked early on.

Possible warning signs include blurred vision, new floaters, inflammation, and sudden changes in eyesight. Because these symptoms can have many causes, the researchers say unexpected vision changes should be checked quickly, since some infections can damage the retina and other vital eye structures.

One of the reviews looked at ocular syphilis, which develops when the bacterium responsible for syphilis affects the eye. Syphilis cases have been rising worldwide, increasing from around 8 million in 1990 to 14 million in 2019. Eye specialists have also reported seeing more ocular syphilis as infections become more common.

Published in the Journal of Ophthalmic Inflammation and Infection, the review notes that ocular syphilis can involve several parts of the eye and may threaten sight. Early diagnosis and antibiotic treatment, however, can improve the chances of preserving vision.

The second review examined ocular toxoplasmosis, a leading cause of infectious inflammation in the back of the eye. It is caused by Toxoplasma gondii, a parasite that may infect up to 30% of people worldwide. Most infected people never develop serious eye disease.

The parasite can stay dormant for years and later reactivate. If it reaches the retina, the light-sensitive tissue at the rear of the eye, it can trigger inflammation and scarring that may affect vision.

Published in Progress in Retinal and Eye Research, the review found diagnosis can be especially challenging in people with weakened immune systems. More than half of reported ocular toxoplasmosis cases in immunocompromised patients had first been misdiagnosed.

People with HIV, patients undergoing cancer treatment or organ transplants, and those taking immune-suppressing medicines may face greater danger from certain eye infections. In these groups, infections can behave differently or worsen more quickly.

The reviews do not suggest that every case of blurred vision or floaters is caused by infection. These symptoms are common and may have many explanations. Still, sudden or significant changes should receive medical attention because waiting too long to treat an infectious cause can raise the risk of lasting damage.

Overall, the findings underline a simple point: many serious infectious eye diseases can be treated, but prompt action is essential. Better awareness among patients and health professionals could help reduce missed diagnoses and prevent avoidable vision loss.

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