Previous research, supported by Seva Foundation, found that CMV retinitis is a neglected cause of blindness in patients with AIDS. CMV retinitis is a viral infection of the retina caused by cytomegalovirus – a cousin of herpes and one of the primary infections in people with advanced AIDS.

Before and after photos of an AIDS patient who had CMV retinitis. She had ganciclovir, a drug used to fight the infection, injected into her left eye five times and this saved her vision.

A pilot program supported by Seva Foundation in Myanmar has shown that CMV retinitis is also associated with an increased death rate, suggesting that the Seva project may not only prevent blindness, but also reduce mortality. The AIDS Eye Initiative started by Seva Foundation and now also funded by Seva Canada serves to globally expand the capacity of AIDS doctors to detect and treat CMV infection at the primary care level. The AIDS Eye Initiative launched by Seva’s Center for Innovation in Eye Care will make established eye examination techniques part of the standard care of AIDS patients at the primary care level in resource-poor settings.

Suzanne Gilbert of Seva Foundation in Berkeley, CA conducts training as part of the AIDS Eye Initiative

Screening techniques for CMV retinitis, based on our training, are showing excellent possibility for controlling CMV retinitis. In the pilot program, 1396 patients were successfully screened, and 129 patients were diagnosed with CMV retinitis. The global epidemic of HIV/AIDS is the worst public health disaster since the Black Plague, with 33 million people infected, 20 million dead, and 12 million children orphaned. This project will reduce blindness and mortality in the emblematic health disaster of our time. The facts about CMV retinitis and AIDS:

1. Over 90% of avoidable blindness in patients with HIV/AIDS is caused by CMV infection and there is little capacity to diagnose or treat this infection in developing countries at the present time
2. 5% to 25% of HIV patients will get CMV retinitis
3. This means 1.7 – 8.5 million people will have potentially blinding CMV retinitis
4. The treatment is highly effective but does not restore already destroyed retina
5. Early diagnosis is critical to prevent blindness
6. Systemic treatment of CMV retinitis has been shown to reduce mortality in AIDS patients
7. Retinal examination may improve diagnosis of Cryptococcal meningitis and TB, two other leading causes of AIDS mortality.

Programs are underway in:

• India: Aravind Eye Hospital, Madurai; Sankara Nethralya Eye Hospital, Chennai.
• Cambodia: Siem Reap (MSF/B); Amite Khymer-Soviet Hospital, Phnom Penh (MSF/F)
• Tanzania: Kilimanjaro Institute for Community Ophthalmology
• Uganda: Mildmay Centre; Infectious Diseases Institute; Mulago Hospital & Ophthalmology/HIV Clinic
• South Africa: Khayelitsha AIDS program (MSF/B); Groote Schur Ophthalmology AIDS clinic; Tygerborg University infectious diseases ward
• Myanmar: Yangon and Myitkina (Kachin State) AIDS program (MSF/H)
• China: MSF/Fr Nanning HIV/ART program, Guangxi Province; #4 Hospital, Nanning; Xinjinag Province Infectious Diseases Hospital, Urumqui