Ocular involvement in chikungunya virus (CHIKV) infection can be present as mild and vision-threatening ocular complications with unilateral or bilateral compromise in both gender and all ages. Precise prevalence and incidence are unknown, but ocular involvement of CHIKV infection is uncommon. Anterior uveitis is the most common syndromic manifestation; nevertheless the infection could manifest posterior segment repercussion, such as retinitis which is the other most usual clinical manifestation. At the beginning of the systemic disease, main ophthalmologic symptoms are conjunctival injection, retro-ocular pain, and photophobia. Ocular pathogenesis of CHIKV infection is not totally clarified; however, findings related to an immune dysregulation and proinflammatory processes are the most accepted theories. The diagnosis of CHIKV is based on polymerase chain reaction, virus isolation, or detection of viral antigens which should be used before the eighth day of systemic illness. After 8 days, chikungunya serologic tests such as IgM ELISA/rapid tests or IgG paired must be used. Actual management is focused according to the clinical context of each patient. While in most instances recovery of vision to normal occurs, CHIKV infection can result in blindness, the visual prognosis depends on various factors, but the common one is the early onset of corticosteroid treatment.
Part of the book: Current Topics in Chikungunya