Sexually transmitted diseases may be diagnosed by OD first

Optometrists and infectious disease specialists can unite to address what has been called a "hidden epidemic" with enormous health and economic consequences: sexually transmitted diseases (STDs).

History tells the story

"If you suspect HIV, order the appropriate laboratory testing, since many of these retinal vasculopathies look the same," Dr. Pelino added.

In a joint presentation on inflammatory retinal and choroidal disorders at the annual SECO meeting, Dr. Pelino's colleague, Joseph J. Pizzimenti, OD, FAAO, told clinicians that optic neuropathy can be the presenting overall sign of HIV.

"Keep this in mind when you identify a patient with disk edema, for example, and need to establish the cause," said Dr. Pizzimenti, who is associate professor, Nova Southeastern University College of Optometry, Fort Lauderdale, FL.

When HIV is mentioned in the patient history, optometrists should ask about viral load and CD4 count, find out if the patient is taking highly active antiretroviral therapy (HAART), and communicate ocular findings to the patient's primary care physician, often an infectious disease specialist. While HAART therapy is a lifesaving cocktail for many HIV patients, its side effects can include immune-recovery uveitis, a chronic intraocular disorder with symptoms of decreased vision and floaters. Clinically, it can present with anterior uveitis, epiretinal membrane formation, macular edema, and vitritis.