Did you know that a doctor can diagnose tuberculosis (TB) with an eye exam? This once commonplace diagnostic tool has been re-discovered as an early indicator of widespread TB thanks in part to Seva's AIDS Eye Initiative Medical Director Dr. David Heiden.
Dr. Heiden’s work through Seva’s AIDS Eye Initiative focuses on training AIDS doctors to recognize diseases that are visible in the eyes of AIDS patients that could cause them to lose their sight or, in certain cases like TB, their lives.
The World Health Organization cites that TB is the most common presenting illness among people living with HIV and it is responsible for a quarter of all HIV-related deaths 360,000 people a year. Teaching doctors to detect TB in HIV/AIDS patients through eye exams allows them to catch and treat the disease early enough that it may save patients’ lives.
Except for Seva supported exploratory work by the AIDS Eye Initiative in the Russian Federation (Saint Petersburg) and Myanmar, eye exams have not been used for this purpose in HIV/AIDS clinics. In an effort to share this information with as many practitioners as possible, Dr. Heiden approached Lancet Infectious Disease, the most prestigious journal in it’s field.
Dr. Heiden and his collaborators wrote a position piece stating their findings in February’s edition of the journal. Eye examination for early diagnosis of disseminated tuberculosis in patients with AIDS is the result of a decade of observations in HIV/AIDS clinics and hospital wards throughout Asia, Africa, and the Russian Federation, plus careful study of the medical literature from a century ago, when TB was common in Western countries. It amounts to rediscovery of what was common practice a century ago: carefully conducted eye exams for patients suspected of having widespread TB.
This method is particularly useful in low-resource settings where more conventional means of identifying TB are not available or are prohibitively expensive. Seva and the authors advocate the World Health Organization to introduce appropriate guidelines incorporating eye exams and to support countries’ efforts to scale up this service.
The publication was a collaborative effort, written by Dr. Heiden, as well as Peter Saranchuk, MD, Jeremy D Keenan, MD, Nathan Ford, PhD, Alan Lowinger, MD, Michael Yen, MD, Prof Joseph McCune, MD, and Professor Narsing A Rao, MD.
Watch this video to learn more about Seva's Aids Eye Initiative
Seva Programs: AIDS Eye Initiative
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Treating HIV-associated cytomegalovirus retinitis with oral valganciclovir and intra- ocular ganciclovir by primary HIV clinicians in southern Myanmar: a retrospective analysis of routinely collected data
Seva Partner David Heiden Wins Humanitarian Service Award
Preventing Avoidable Blindness from AIDS in the Ukraine
CMV Retinitis: the way forward in China and SE Asia
CMV Retinitis the Neglected Disease of the HIV/AIDS pandemic
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Eye examination for early diagnosis of disseminated tuberculosis in patients with AIDS (PDF)
Training clinicians treating HIV to diagnose cytomegalovirus retinitis (PDF)
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