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Ocular histoplasmosis is caused by fungal spores from a lung infection that can travel to the eyes and cause central vision loss. Laser surgery can prevent further damage, but lost vision cannot be restored. Antifungal and anti-inflammatory drugs are not effective, and the exact mechanism of how the spores migrate to the eyes is unknown.
Ocular histoplasmosis is a possible complication of a type of fungal lung infection. The airborne spores of the fungus Histoplasma capsulatum can attach themselves to the inner lining of the lungs and may or may not cause immediate symptoms. If the fungal spores manage to reach the bloodstream, they can travel to the eyes and become embedded in the choroidal layer above the retina. People with ocular histoplasmosis may experience mild to severe central vision loss due to inflammation of blood vessels and scarring in the eye. Treatment in the form of laser surgery can usually prevent further damage to the eye, but most people who develop ocular histoplasmosis don’t regain the vision they’ve already lost.
The exact mechanisms by which fungal spores migrate from the lungs to the eyes are not known. In fact, there is usually no direct evidence that fungus exists in the eye in people who have been diagnosed with ocular histoplasmosis. Nearly every person who has the disorder, however, has a previous history of a fungal lung infection. It may take several months or even years for eye problems to develop after coming into contact with Histoplasma capsulatum.
The choroid layer of the eye contains tiny blood vessels that feed the retina. Ocular histoplasmosis causes inflammation in existing vessels and the growth of new, very delicate vessels that are prone to bleeding. As a result, scars and lesions can arise in the central portion of the retina. An affected eye has trouble with sharp focus, which is needed to read text, make eye contact, or drive a vehicle safely. Peripheral vision is usually left intact.
A person who believes they may have ocular histoplasmosis symptoms should visit an ophthalmologist as soon as possible. Your doctor may be able to see tiny specks in your eye called histological spots, which are small scars above the choroidal layer that are common with ocular histoplasmosis. A detailed examination might also reveal swelling of the retina and blood vessel overgrowth.
Antifungal and anti-inflammatory drugs have not been shown to be helpful in treating ocular histoplasmosis. The most effective treatment is a surgical procedure called laser photocoagulation. During the surgery, a high-intensity laser beam is used to burn off the abnormal blood vessels. Photocoagulation is very effective in most cases in stopping future vision degeneration. It cannot, however, restore lost vision. Specialized contact lenses and sessions with trained vision specialists may be able to help some patients see better and learn to overcome their handicaps.
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