What is Histoplasmosis

Histoplasma capsulatum is a soil born fungus that is endemic to the Ohio and Mississippi river valleys. Humans and other mammals breath in these fungi that are found in the soil and in bird droppings. Once infected in the lungs, Histoplasmosis can move to the liver, kidneys, spleen and even the eye. item8

How Histoplasmosis affects the eye - The most common ocular manifestation related to Histoplasmosis is Presumed Ocular Histoplasmosis Syndrome (POHS).

Over 80 million people are at risk for POHS, and of these more than 60% are likely to have a positive skin test.

POHS presents in the eye commonly as atrophic scars in the retina, or "punched-out" lesions due to their appearance (as seen in the Retinal photos to the right). Scarring around the optic nerve called peripapillary atrophy is very common, but the most visually significant finding can be blood vessel growth in the macula, or choridal neovascular membrane (CNV).

These neovascular membranes cause a visual distortion or metamorphosias, and can lead to scarring and retinal detachments. If POHS leads to this macular involvement it is crucial to be properly treated as soon as possible to avoid long-term vision loss.

Is Histoplasmosis easy to diagnose - Although POHS is endemic in the Ohio River Valley it is also very common in Columbus. Dr. Miller completed his residency in Southern Ohio and is well trained in the diagnosis and treatment of Ocular Histoplasmosis.

Diagnosis of POHS may be easily made during an annual Lifestyle Eye Exam with Retinal Photodocumentation. Once diagnosed and based on severity, it is common to monitor POHS findings at a minimum of every 6 months. Patients are also asked to monitor their vision as well with daily Amsler Grid testing. Any patients that notice any changes in their vision are asked to return or contact Gahanna Vision Center immediately.


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