# 5169
Although conjunctivitis has been associated with Chikungunya in the past, Indian media sources are reporting on the appearance of more serious eye problems among infected patients.
First a report from the Times of India, then some background on Chikungunya, and other reports of accompanying eye infections.
Chikungunya of the eye makes an appearance
Dec 21, 2010, 02.55am IST
CHENNAI: The chikungunya virus, which leaves people with severe pain in the joints, is now affecting the eye too. Several samples of eye serum sent from the Government Ophthalmic Hospital in Egmore have tested positive for chikungunya at the King Institute of Preventive Medicine.
"Medical journals have reported ocular manifestation of the virus. In most cases, people who reported the infection had high fever, joint pain and blurring of vision. We have sent samples to the lab. It requires a detailed study," said Government Ophthalmic Hospital superintendent Dr Vasantha.
Indian doctors are warning Chikungunya patients who experience ocular problems (photophobia, pain, swelling, blurred vision) to seek out an ophthalmologist immediately.
Chikungunya is a mosquito borne alphavirus (similar to Australia’s Ross River Virus, and EEE), of East African origin, that typically produces a fever, severe muscle and joint pain, and headaches.
They symptoms usually go away after a few weeks, but some patients can retain permanent disability.
First described in 1955 in Tanganyika, it was only sporadically seen over the years in eastern and central Africa. That is, until 2005, when Chikungunya made a jump to the Indian Ocean island of Réunion.
In the five years since that time, Chik has migrated to India, Indonesia, and much of south east Asia. It has even been imported into Italy.
I told the story in It's A Smaller World After All, but the crux of the matter being that a traveler, returning from India, brought the virus to Italy in 2007 which led to more than 290 cases reported in the province of Ravenna, which is in northeast Italy.
Many infectious disease specialists have expressed concerns that Florida – which has recently seen a return of Dengue fever after more than 5 decades – could one day face the establishment of chikungunya as well.
While the Indian media reports over the past couple of days suggest these ocular manifestations are something new, a quick search of the literature shows that rare, but documented cases of retinitis, optic neuritis (inflammation of the optic nerve), and acute iridocyclitis have all been associated with Chikungunya infection in the past.
Ophthalmology. 2008 Feb;115(2):287-91.
Ocular manifestations associated with chikungunya.
Mahendradas P, Ranganna SK, Shetty R, Balu R, Narayana KM, Babu RB, Shetty BK.
Arch Ophthalmol. 2007 Oct;125(10):1381-6.
Optic neuritis associated with chikungunya virus infection in South India.
Mittal A, Mittal S, Bharati MJ, Ramakrishnan R, Saravanan S, Sathe PS.
Indian J Ophthalmol. 2009 Mar-Apr;57(2):148-50.
So the real question would appear to be – just how prevalent are these reported chikungunya-related eye infections?
And we don’t seem to get an answer to that in these reports. `Several’ is as close to quantifying the number of cases as it comes.
But I promise, we’ll keep an eye on it.
