Ebola and the eye
Managing ophthalmic manifestations of virus heightens screening, treatment protocols
Take-home message: The unexpected discovery of viable Ebola virus in the eye of a patient who had recovered from the systemic disease has strengthened efforts to learn more about ophthalmic and systemic complications of Ebola survivors and has translated to management and follow-up strategies in West Africa.
Reviewed by Steven Yeh, MD, and Jessica G. Shantha, MD
Atlanta—Infectious disease specialist Ian Crozier, MD, made medical headlines twice in recent months—first as one of the critically ill healthcare workers transported from West Africa to the United States after being diagnosed with acute Ebola virus disease (EVD), and again when the live virus was found in his aqueous humor weeks after he had been declared free of the disease.
Dr. Crozier’s development of anterior uveitis—which progressed to a sight-threatening panuveitis—alerted the medical community that the post-EVD syndrome has implications for individual and public health, according to Steven Yeh, MD, one of the physicians at Emory University Hospital, Atlanta, who treated Dr. Crozier.
“Even though the acute outbreak status has improved significantly and has faded from media attention, there are still thousands of survivors who require ongoing care for their ophthalmologic issues as well as their systemic issues,” said Dr. Yeh, associate professor of ophthalmology, Emory Eye Center.
“Many groups are working together to think about ways that we can strategize how we can not only screen patients but provide a higher level of care for a potential uveitis outbreak of a larger magnitude,” he added. “In addition, their focus is on disseminating more knowledge about this disease and to have discussions about complicated scenarios that are novel.”
Other issues that are ongoing for Ebola survivors who have already lost so much are mental health issues, psychosocial stressors, problems with pregnancy, arthritis, and arthralgia, Dr. Yeh noted.