The Eye and the Zika Virus

Ocular involvement in Zika virus (ZIKV) infection can be present both in adults and infants as acquired and congenital diseases respectively. Through experimental studies, there has been clarified important mechanisms of ocular pathogenesis that allow the establishment of potential objectives for antiviral drugs development. The spread of the virus at the ocular level could be hematogenous or axonal, however the hematogenous route through the choroid is suggested as the most important initial mechanism for infection. Ocular manifestations vary according to the age of presentation, being mild and self-limited in adults and potentially devastating in children, related to congenital Zika syndrome (CZS). Ocular diagnosis is made based in clinical features and contact/travel history to countries of epidemiological importance; fundoscopy, optical coherence tomography, fluoresceinic/green indocianine angiography, cultures, serological and molecular tests are useful diagnostic tools. Ocular management is focused according to the clinical context of each patient. Prevention is carried out in a comprehensive manner and further research is directed to vaccine development and specific antiviral treatment. Proper attention requires a multidisciplinary team in order to reach complete visual evaluation and early rehabilitation.