Zika May Be Visible in Infected Infant’s Eyes

All infants with potential Zika virus exposure should undergo vision screening examinations

Infants with possible maternal Zika virus exposure should undergo eye exams, new research suggests.

"Eye abnormalities may be the only initial finding in congenital Zika virus infection,” reported Andrea A. Zin, MD, PhD, from the Departamento de Pesquisa Clinica, Instituto Nacional de Saúde da Mulher, Rio de Janeiro, Brazil, and colleagues.

“All infants with potential Zika virus exposure should undergo screening eye examinations regardless of central nervous system abnormalities, timing of maternal infection during pregnancy or laboratory confirmation," said Dr. Zin.

This research, as well as previous research, has found that eye abnormalities occur not only in infants with microcephaly.

These researchers acknowledge they "cannot affirm with absolute certainty" that all vision issues were Zika related.

Eye abnormalities were more common when mothers were infected during the first trimester.

But they could occur with infection at any time during the pregnancy.

This study reports 41.7% of the tested babies occurred in the absence of microcephaly in RT-PCR-confirmed cases of Zika virus infection.

The Centers for Disease Control and Prevention (CDC) guidelines recommend eye screening only if a laboratory confirms a congenital Zika infection. Because those tests are not always available, eye abnormalities may be missed.

The CDC’s infant guidance includes recommendations for testing infants for congenital Zika infection and clinical management recommendations for infants with evidence of Zika virus infection, both with and without apparent birth defects, to ensure careful screening and monitoring of infant development.

For infants with congenital Zika virus infection, care is focused on diagnosing and managing conditions that are present, monitoring the child’s development over time, and addressing problems as they arise.

The authors have disclosed no relevant financial relationships. This study was supported by the Brazilian National Council for Scientific and Technological Development, the National Institute of Allergy and Infectious Diseases, and the National Eye Institute.