Eye Zika Virus

Eye Zika Virus means eye problems caused by infection with the Zika virus. Zika is a virus spread mainly by Aedes mosquitoes. It can also spread through sex, blood products, and from a pregnant person to the baby. Most people have no symptoms or only mild ones like fever, rash, joint pains, and red eyes. But Zika can also involve the eye. In adults, it may cause red, irritated eyes (conjunctivitis), inflammation inside the eye (uveitis or iridocyclitis), and sometimes retina or macula problems that blur vision. In babies who were exposed in the womb, Zika can damage the back of the eye and the optic nerve and may lead to serious, long-lasting vision loss. World Health Organization+1AAOPMC

Zika eye disease happens in two main settings. First, acute infection in children or adults can inflame the eye surface or the inside of the eye. Second, congenital infection (exposure during pregnancy) can cause “congenital Zika syndrome,” which includes brain problems and eye abnormalities such as scarring or thinning in the macula and choroid, and optic nerve changes. These eye findings can be seen on careful eye exam and on special scans like OCT. PMCJAMA NetworkAAO

Zika virus is a mosquito-borne flavivirus that can also spread through sex and from a pregnant person to the fetus. Most infected adults have no symptoms or only mild, flu-like illness with red eyes (viral conjunctivitis). In some people, the eyes become inflamed (conjunctivitis, anterior uveitis, or—less often—posterior uveitis/maculopathy). In babies exposed during pregnancy (congenital Zika syndrome), the retina and optic nerve may be under-developed or scarred, which can reduce vision. There is no licensed medicine that kills Zika and no approved vaccine as of today; eye care focuses on comfort, controlling inflammation, watching for complications, and protecting others from infection. CDC+1EyeWikiPMC

Viral conjunctivitis (red, watery, gritty eyes), acute anterior uveitis (light sensitivity, aching), and, rarely, maculopathy/retinal or optic-nerve changes; in infants with congenital exposure, characteristic macular scars, pigment mottling, and optic-nerve pallor may be seen. A slit-lamp exam is advised if someone with acute Zika symptoms has a red, painful, or light-sensitive eye.

Doctors confirm Zika with lab tests. A nucleic acid test (NAAT/RT-PCR) may detect virus early for a short time. IgM antibody tests (like Zika MAC-ELISA) can help later, but may cross-react with related viruses, so results sometimes need neutralization tests. Because virus levels in blood fall quickly, a negative PCR does not rule out infection. CDCU.S. Food and Drug Administration

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Types

1) Acute Zika conjunctivitis (surface eye infection).
This is a sudden, non-purulent (watery) red eye during Zika illness. It usually comes with mild irritation, tearing, and light sensitivity. Vision is often okay. It resolves in days to a couple of weeks as the infection passes. World Health OrganizationPMC

2) Anterior uveitis / iridocyclitis.
Inflammation occurs inside the front of the eye (iris and ciliary body). Patients report pain, light sensitivity, and blurred vision. Doctors may see cells and flare in the anterior chamber and sometimes high eye pressure (“hypertensive iridocyclitis”). PMCJAMA Network

3) Keratitis / trabeculitis.
The cornea can become inflamed (keratitis), and the eye’s drainage tissue (trabecular meshwork) can be inflamed (trabeculitis), which may raise eye pressure and blur vision until inflammation settles. PMC

4) Posterior uveitis / retinitis / chorioretinitis.
Inflammation affects the retina and/or choroid in the back of the eye. People may notice floaters, scotomas (blank spots), or decreased vision. Doctors see white retinal lesions and vascular changes. PMC

5) Unilateral acute maculopathy.
One eye develops acute injury in the macula (the central retina). Vision drops suddenly. OCT often shows outer retinal and RPE loss. Recovery can be slow and incomplete. PMCJAMA Network

6) Neuro-ophthalmic involvement.
The optic nerve can look pale or small (hypoplastic) in congenital cases, and babies may have poor visual behavior even if the front of the eye looks normal. PMC

7) Congenital Zika syndrome (CZS) ocular disease.
When infection happens in pregnancy, the baby can have microcephaly plus eye defects: macular scarring, colobomatous-like excavations, retinal and choroidal thinning, pigment mottling, optic nerve hypoplasia/pallor, congenital glaucoma, and microphthalmia. These can severely limit vision. PMCAAOPubMed

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Causes

1) Infection by Aedes mosquito bite.
A bite from an infected Aedes mosquito can introduce Zika virus into the bloodstream, which can then reach the eye. World Health Organization

2) Sexual transmission.
Unprotected sex with an infected partner can spread Zika, increasing the chance of systemic and eye involvement. World Health Organization

3) Blood transfusion or exposure to infected blood.
Although rare, blood products can transmit Zika and lead to eye disease as part of systemic infection. World Health Organization

4) Congenital (mother-to-baby) transmission during pregnancy.
If the mother is infected, the virus can cross the placenta and affect the baby’s brain and eyes. World Health Organization

5) Infection during early pregnancy (first or second trimester).
Earlier exposure in fetal development may cause more severe eye malformations because the retina and optic nerve are forming. (This is an inference based on timing of fetal organogenesis described in CZS literature.) CDC NDC

6) High viral load in acute infection.
Higher amounts of virus early on may increase the chance of ocular inflammation before the immune system clears it. (Inferred from the short window of detectable viremia and acute ocular findings.) CDCPMC

7) Direct viral invasion of ocular tissues.
Zika is neurotropic; it can infect neural tissue, including retina and optic nerve, causing local damage. PMC

8) Immune-mediated inflammation.
The immune system’s response to Zika may inflame the iris, ciliary body, and retina, leading to uveitis. JAMA Network

9) Breakdown of the blood-ocular barrier.
Systemic inflammation from Zika can weaken protective barriers, allowing immune cells and mediators to enter the eye and cause damage. (Mechanistic inference consistent with uveitis pathophysiology reported with Zika.) PMC

10) Prior exposure to related flaviviruses.
Cross-reactive antibodies may complicate diagnosis and could, in theory, alter immune responses; at minimum, they confound serology used to detect Zika. CDC

11) Travel or residence in endemic or outbreak regions.
Living in or traveling to places with Aedes mosquitoes increases infection risk. World Health Organization

12) Poor mosquito control or lack of personal protection.
No repellents, no window screens, and standing water near homes raise the chance of infection and downstream eye issues. World Health Organization

13) Co-infection with other arboviruses (e.g., dengue, chikungunya).
These share the same vector and can present similarly; overlapping infections complicate care and may muddy diagnosis of Zika-related eye disease. OKC-County Health Department

14) Immunosuppression.
Weakened immunity may allow more intense or prolonged viral effects, including in the eye. (General inference; not Zika-specific guidance.)

15) Genetic or developmental vulnerability of fetal eye tissues.
During fetal development, retinal and optic nerve cells are sensitive to viral injury, which explains severe congenital eye findings. PMC

16) Inflammation of the trabecular meshwork (trabeculitis).
When the drainage tissue is inflamed in Zika, eye pressure can rise and damage can follow. This is a direct mechanism for secondary glaucoma. PMC

17) Viral injury of retinal pigment epithelium (RPE) and outer retina.
OCT studies in affected infants show outer retinal and RPE loss, which can permanently reduce central vision. JAMA Network

18) Optic nerve involvement (neuritis or hypoplasia in CZS).
Damage to the optic nerve or underdevelopment in babies directly impairs visual signaling to the brain. PMC

19) Congenital glaucoma linked to CZS.
Abnormal eye development or inflammation can block fluid outflow, raising pressure and damaging the optic nerve. PMC

20) Systemic complications that reduce care access.
During outbreaks, overwhelmed health systems and limited follow-up can delay eye care, allowing treatable inflammation or pressure elevations to persist. (Public-health inference aligned with outbreak experience.) Vox

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Symptoms

1) Red eye.
The white of the eye looks pink or red due to conjunctival inflammation during acute Zika illness. World Health Organization

2) Watery discharge and tearing.
The eye waters more than usual; discharge is usually clear, not thick or pus-like. Prevent Blindness

3) Gritty or foreign-body sensation.
It feels like sand in the eye because the surface is inflamed.

4) Light sensitivity (photophobia).
Bright light hurts because the cornea or iris is inflamed.

5) Eye ache or deep pain.
Uveitis can cause aching pain, sometimes with headache. JAMA Network

6) Blurred central vision.
Macular involvement or active inflammation reduces sharpness of central sight. PMC

7) Floaters.
Small moving specks appear, caused by inflammatory debris in the vitreous gel.

8) Halos or glare at night.
Corneal swelling or high eye pressure can scatter light and create halos.

9) Decreased contrast or color dullness.
Retinal or optic nerve changes can make colors and contrast look faded.

10) Blind spots (scotomas).
Macular lesions cause small missing areas in the visual field. PMC

11) Peripheral field defects.
If larger retinal regions are involved, side vision can shrink.

12) Transient double vision.
If the eye is very irritated or if neurologic involvement occurs, images may misalign briefly. (Less common; neuro-ophthalmic involvement is described in CZS.)

13) Eyelid swelling.
Mild swelling can accompany conjunctivitis.

14) Systemic symptoms alongside eye symptoms.
Many people notice rash, low-grade fever, and joint pain at the same time as red eyes. World Health Organization

15) In babies with CZS: poor visual attention or nystagmus.
Infants may not fix and follow faces well and can have shaky eye movements due to retinal and brain injury. PMC

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Diagnostic tests

Physical Exam (done in the clinic room)

1) Visual acuity test.
Reading letters or matching symbols checks how sharp vision is. A drop in acuity suggests macular disease, inflammation, pressure rise, or media haze.

2) External eye inspection.
The doctor looks for redness, swelling, discharge, and light sensitivity. Zika conjunctivitis is usually watery and non-purulent. World Health Organization

3) Pupillary exam.
Light is shone into each eye to see if pupils react normally. Poor or asymmetric reactions can point to optic nerve problems, which are reported in congenital cases. PMC

4) Ocular motility and alignment.
The doctor checks how the eyes move and align to rule out nerve palsies or central issues that may accompany congenital infection.

5) Confrontation visual fields.
Simple bedside field testing screens for missing areas of vision from macular or optic nerve damage.

Manual tests (hands-on ophthalmic procedures)

6) Slit-lamp biomicroscopy.
A microscope with a bright slit of light magnifies the front of the eye to find signs of conjunctivitis, keratitis, or anterior uveitis (cells/flare). This is key for diagnosing uveitis described with Zika. PMC

7) Applanation tonometry (eye pressure measurement).
Raised intraocular pressure can occur with trabeculitis or steroid response. Measuring pressure helps prevent optic nerve damage. PMC

8) Dilated fundus examination (indirect ophthalmoscopy).
After dilating drops, the retina and choroid are examined for white lesions, pigment changes, hemorrhages, or macular scars consistent with Zika posterior uveitis or maculopathy. PMC

9) Amsler grid testing.
A small grid is used to detect central distortion or blind spots from macular disease.

10) Color vision testing (e.g., Ishihara plates).
Checks for color loss that may occur with macular or optic nerve dysfunction in congenital cases.

Lab and Pathological tests

11) Zika NAAT/RT-PCR on serum and/or urine (early).
This detects viral RNA in the first days of illness. Because viremia is brief and low, a negative PCR does not rule out recent infection. Timing is crucial. CDC

12) Zika IgM antibody (MAC-ELISA).
IgM appears about a week after symptoms start and can persist for months to years. Positive results support recent infection but can cross-react with other flaviviruses. CDCU.S. Food and Drug Administration

13) Plaque reduction neutralization test (PRNT).
When IgM is positive but cross-reaction is suspected, PRNT helps confirm Zika by measuring specific neutralizing antibodies (used in reference labs). CDC

14) Arboviral panel to rule out dengue and chikungunya.
Because symptoms overlap (fever, rash, arthralgia, red eyes), testing for co-circulating viruses helps clarify the cause of eye findings. OKC-County Health Department

15) Maternal and neonatal testing in pregnancy cases.
For suspected congenital infection, clinicians test maternal samples, amniotic fluid when indicated, and infant serum/urine after birth to document exposure. CDC maintains clinical case definitions for congenital Zika disease with brain and eye findings. CDC NDC

16) Anterior chamber paracentesis (select cases).
In difficult uveitis, a tiny sample of aqueous humor may be taken to look for viral material, but this is uncommon and reserved for special situations because it is invasive.

Electrodiagnostic tests

17) Electroretinography (ERG).
ERG measures how retinal cells respond to flashes of light. In congenital Zika, ERG may show reduced function that matches OCT damage in the outer retina. (Supported by the established outer-retinal/RPE loss on OCT in CZS.) PubMed

18) Visual Evoked Potential (VEP).
VEP checks the visual pathway from retina to the brain. Abnormal VEP in infants with CZS may reflect optic nerve and cortical involvement that reduces visual responses. PMC

Imaging tests

19) Optical Coherence Tomography (OCT).
OCT is a painless scan that shows cross-sections of the retina. In infants with congenital Zika, OCT often shows loss of the outer retina and retinal pigment epithelium, plus retinal and choroidal thinning and colobomatous-like excavations in severe cases. In adults with maculopathy, OCT helps track recovery. JAMA NetworkAAO

20) Fundus photography, autofluorescence, and fluorescein angiography (FA).
Photos document lesions. Autofluorescence highlights RPE damage. FA shows leakage and non-perfusion in inflamed or damaged retina—useful for chorioretinal Zika lesions and for following change over time.

Non-pharmacological treatments (therapies & other measures)

(What they are • Why used • How they help)

1. Cool compresses on closed lids — For burning/itchy, watery eyes. Cold reduces surface nerve activity and vessel dilation, easing irritation from viral conjunctivitis.

2. Preservative-free saline rinses — Gentle irrigation reduces debris and inflammatory mediators on the eye surface.

3. Strict hand hygiene — Cuts down self-inoculation and spread to family; viruses move via fingers and tears.

4. Single-use tissues & towel hygiene — Avoid sharing towels/pillows; discard tissues to reduce household transmission.

5. Frequent artificial-tear breaks (non-medicated) — Lubricates the ocular surface, dilutes inflammatory molecules, and improves comfort in viral conjunctivitis.

6. Contact-lens holiday — Lenses can worsen surface inflammation and trap virus/debris; pausing wear lowers risk of keratitis.

7. Sunglasses / photophobia control — Tints reduce light scatter on an inflamed iris/ciliary body, easing uveitis light-sensitivity.

8. Screen-time pacing and blink breaks — Preserves tear film stability and reduces burning from evaporation during recovery.

9. Humidified air & hydration — Moist air and adequate fluids support the tear film and mucosal immunity.

10. Sleep optimization — Rest helps immune coordination and symptom tolerance.

11. Head-of-bed elevation — A small wedge can reduce morning eyelid edema and tearing.

12. Warm compresses with lid hygiene (only if crusting) — Softens discharge and keeps meibomian oils flowing; do not rub aggressively.

13. Avoid eye makeup & lash extensions temporarily — Minimizes irritants and contamination reservoirs.

14. Do not share eye drops — Prevents cross-infection; each person uses their own bottle.

15. Stop “get-the-red-out” vasoconstrictor drops — Rebound redness may worsen; they don’t treat the virus.

16. Low-vision support for infants with congenital disease — Early visual stimulation and habilitation maximize developmental outcomes.

17. Protective hats/repellent use outdoors — Reduces new mosquito bites and secondary exposures during convalescence. CDC

18. Safe-sex practices (condoms/abstinence) — Limits sexual transmission while virus may persist in semen. CDC

19. Prompt ophthalmology follow-up if pain/photophobia/blur — Uveitis needs early anti-inflammatory care to protect vision. PMC

20. Education for caregivers of exposed infants — Teaches signs of poor fixation, nystagmus, or strabismus so care can be started early. AAO

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Drug treatments

Important safety note: There is no approved antiviral for Zika. Medications below treat symptoms or complications (like uveitis or high eye pressure). Start anything beyond simple lubricants only under an eye specialist, especially in pregnancy. Avoid aspirin/NSAIDs until dengue is excluded. CDC+1

1. Acetaminophen (Paracetamol) — Class: analgesic/antipyretic. Dose: adults 500–1,000 mg every 6–8 h (max 3–4 g/day). When: fever/ache. Why/how: central COX modulation lowers fever/pain without platelet effects. Side effects: liver toxicity if overdosed/alcohol use. CDC

2. Cetirizine — Class: oral H1-antihistamine. Dose: 10 mg daily. When: itchy/watery eyes/nasal symptoms. How: blocks histamine H1 receptors. Side effects: mild drowsiness/dry mouth.

3. Loratadine — Class: oral H1-antihistamine. Dose: 10 mg daily. How: peripheral H1 blockade. Side effects: headache, dry mouth (usually non-sedating).

4. Fexofenadine — Class: oral H1-antihistamine. Dose: 120–180 mg daily. How: H1 blockade. Side effects: dyspepsia, rare dizziness.

5. Diphenhydramine (night-time only if needed) — Class: sedating H1-antihistamine. Dose: 25–50 mg every 6 h PRN. How: central/peripheral H1 block. Side effects: sedation, anticholinergic effects—avoid in older adults.

6. Olopatadine 0.1–0.2% eye drops — Class: topical antihistamine + mast-cell stabilizer. Dose: 1 drop BID. How: immediate H1 block + reduces degranulation. Side effects: transient sting.

7. Ketotifen 0.025% eye drops — Class: topical antihistamine/mast-cell stabilizer. Dose: 1 drop BID. How: similar to olopatadine. Side effects: stinging/dry eye.

8. Preservative-free artificial tears — Class: ocular lubricants. Dose: 1–2 drops up to QID–hourly. How: restores tear volume, dilutes viral debris/cytokines. Side effects: rare blur right after instillation.

9. Lubricating gel/ointment (night) — Class: ocular lubricant (long-acting). Dose: small ribbon at bedtime. How: longer retention reduces morning irritation.

10. Prednisolone acetate 1% eye drops — Class: topical corticosteroid. Dose: 1 drop q1–2 h then taper per specialist. When: significant anterior uveitis. How: glucocorticoid anti-inflammatory gene modulation. Risks: ↑IOP, cataract, worsen herpes; specialist supervision required. EyeWiki

11. Loteprednol 0.5% — Class: “soft” topical steroid. Dose: QID then taper. How: local anti-inflammatory with lower IOP risk vs prednisolone; still needs monitoring. EyeWiki

12. Cyclopentolate 1% — Class: cycloplegic. Dose: 1 drop TID. When: photophobia/ache from uveitis. How: relaxes ciliary body/iris; prevents posterior synechiae. Side effects: blur at near, light sensitivity. canadianjournalofophthalmology.ca

13. Homatropine 2–5% — Class: cycloplegic. Dose: BID–TID. How/risks: as above; avoid in narrow angles. canadianjournalofophthalmology.ca

14. Atropine 1% — Class: long-acting cycloplegic. Dose: daily to BID for severe spasm. How: strong muscarinic blockade. Risks: prolonged dilation; caution in kids. canadianjournalofophthalmology.ca

15. Timolol 0.5% — Class: topical beta-blocker for secondary (uveitic/steroid-related) ocular hypertension. Dose: 1 drop BID. How: ↓aqueous humor. Side effects: bradycardia/bronchospasm (systemic absorption).

16. Brimonidine 0.2% — Class: α2-agonist. Dose: 1 drop TID. How: ↓aqueous + ↑uveoscleral outflow. Side effects: fatigue, allergy.

17. Dorzolamide 2% / Brinzolamide 1% — Class: topical carbonic anhydrase inhibitor. Dose: TID (or BID for brinzolamide). How: ↓aqueous production. Side effects: bitter taste, stinging.

18. Prednisone (oral) — Class: systemic corticosteroid. Dose: typically 0.5–1 mg/kg/day short-term for severe posterior uveitis/optic neuritis under specialist care. How: systemic anti-inflammatory; Risks: glucose, mood, infection. AAO

19. Adalimumab (for refractory non-infectious uveitis) — Class: anti-TNF biologic. Dose: per label (e.g., 80 mg load → 40 mg every 2 weeks). When: steroid-sparing for non-infectious uveitis that threatens vision. How: blocks TNF-α. Risks: infection reactivation; specialist/label indications apply. PMCEyeWiki

20. Topical antibiotic ointment (e.g., erythromycin) only if bacterial superinfection — Viral conjunctivitis does not benefit from antibiotics; avoid routine use. How: limits secondary bacterial overgrowth. Risks: allergy/resistance; use only when indicated. AAO

Not recommended: routine topical steroids for simple viral conjunctivitis; systemic NSAIDs/aspirin at illness onset until dengue is ruled out. AAOCDC

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Dietary “molecular” supplements

There’s no proof these treat Zika; they may support surface comfort or general immunity. Discuss with your clinician, especially if pregnant.

1. Omega-3 fatty acids (fish oil or algal DHA/EPA) — 1–2 g/day; support tear film lipid layer and anti-inflammatory signaling.

2. Vitamin D3 — 1,000–2,000 IU/day if deficient; supports innate/adaptive immune balance.

3. Vitamin C — 200–500 mg/day from diet/supplement; antioxidant for mucosal health.

4. Zinc — 8–11 mg/day; cofactor for epithelial repair and immunity; avoid excess (>40 mg/day).

5. Vitamin A (dietary beta-carotene) — from dark-green/orange vegetables; supports ocular surface/retina.

6. Lutein + Zeaxanthin — 10 mg + 2 mg/day; macular antioxidants that support retinal health.

7. Selenium — 55 µg/day; antioxidant enzyme cofactor; do not exceed upper limit.

8. N-acetylcysteine (NAC) — 600 mg once–twice daily; mucolytic/antioxidant that may reduce oxidative stress on the surface.

9. Probiotics — as labeled; gut-eye axis effects are emerging; choose reputable products.

10. Quercetin (food-first approach) — onions/apples/berries; bioflavonoid with anti-oxidant properties; supplement only if your clinician agrees.

Advanced immune-modulating options

These are specialist-only, steroid-sparing medicines for serious non-infectious ocular inflammation (e.g., significant Zika-associated uveitis). Doses vary; monitoring is essential.

1. Methotrexate — 15–25 mg once weekly + folic acid; antimetabolite that reduces T-cell activity. Helps maintain remission, spare steroids.

2. Mycophenolate mofetil — 1–1.5 g twice daily; inhibits lymphocyte purine synthesis; useful in posterior/panuveitis.

3. Azathioprine — 1–2.5 mg/kg/day; purine analogue that dampens adaptive immunity.

4. Cyclosporine — 2–5 mg/kg/day; calcineurin inhibitor blocking T-cell activation.

5. Adalimumab — biologic anti-TNF-α; label-approved for certain non-infectious uveitides threatening vision.

6. Systemic corticosteroids — short-term bridge (e.g., prednisone) while steroid-sparing agents take effect; taper as possible.
   Why/how they help: they quell pathologic intraocular inflammation to protect the retina/optic nerve and reduce pain/photophobia. Risks: infection reactivation, liver/kidney effects, cytopenias; regular labs needed. EyeWikiPMCSpringerOpen

No approved “stem-cell drugs” for Zika eye disease. Cell therapies for ocular inflammation remain experimental and should only be accessed in regulated clinical trials.

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Surgeries

1. Strabismus surgery (in congenital Zika syndrome) — What/why: realigns the eyes to improve ocular alignment and social interaction; may aid visual development alongside therapy. Evidence: reports show functional gains after surgery in children with congenital Zika syndrome. PMC

2. Cataract extraction — Why: if steroid-induced or inflammatory cataract limits vision during/after uveitis; restores optics once inflammation is quiet.

3. Glaucoma surgery (trabeculectomy/tube) — Why: for uveitic or steroid-related high eye pressure that does not respond to drops, to protect the optic nerve.

4. Pars plana vitrectomy — Why: rare; for dense inflammatory vitreous opacities or complications (e.g., non-clearing hemorrhage) impacting vision.

5. Laser or surgical management of secondary retinal neovascular complications — Why: very uncommon in Zika; used if sight-threatening complications appear under specialist care.

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Prevention tips

1. Avoid mosquito bites day and night (Aedes bite in daylight too). Use EPA-registered repellents (DEET, picaridin), wear long sleeves, and use screens/air-conditioning. CDC

2. Eliminate standing water around home (buckets, tires, flowerpots).

3. Use condoms or abstain during and after illness to prevent sexual transmission. CDC

4. Postpone non-essential travel to areas with Zika if pregnant or planning pregnancy; seek pre-travel advice. CDC

5. Prenatal care with ultrasound and pediatric eye checks after any suspected exposure in pregnancy. AAO

6. Do not donate blood or semen during and soon after illness, per public-health guidance.

7. Do not use aspirin/NSAIDs at illness onset until dengue is excluded. CDC

8. Household hygiene: personal towels, frequent hand-washing, disinfect high-touch surfaces.

9. Stay home while febrile to reduce spread and allow rest.

10. Eye-safe habits: stop contact lenses while eyes are red; avoid eye rubbing.

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When to see a doctor

• Severe eye pain, marked light-sensitivity, or sudden vision drop — possible uveitis, keratitis, or optic/retinal involvement; needs urgent slit-lamp/fundus exam. PMC

• Red eye with thick discharge, swelling, or fever that worsens after 3–5 days of care.

• New floaters, flashes, or a shadow in vision.

• High fever, bleeding, or extreme weakness (consider dengue or other illness). CDC

• Pregnant or planning pregnancy with any exposure or illness—seek obstetric and ophthalmic advice. CDC

• Infants exposed in utero: any poor fixation, nystagmus, abnormal red reflex, or eye misalignment—needs pediatric ophthalmology. AAO

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What to eat and what to avoid

1. Eat more of: water and oral rehydration fluids; broths and soups with lean protein; citrus and berries (vitamin C); leafy greens & orange vegetables (beta-carotene/lutein); zinc-rich foods (beans, lentils, seeds); omega-3 fish (e.g., sardines) to support ocular surface comfort.
2. Limit/avoid: alcohol (stresses the liver, especially if using acetaminophen); overly salty/ultra-processed foods (worsen dehydration); high-sugar snacks (energy spikes then crashes); aspirin/NSAIDs early in illness until dengue is ruled out; contact-lens wear until eyes are white and comfortable again. CDC

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FAQs

1) Is there a cure or vaccine for Zika?
No approved antiviral or vaccine exists yet; care is supportive and preventive. CDC

2) Can Zika affect only the eyes?
Eye redness can be part of the typical illness, and uveitis can occur; babies exposed in utero may have retinal/optic-nerve findings. EyeWikiAAO

3) How long does red eye last?
Viral conjunctivitis symptoms usually improve over 1–2 weeks with comfort care.

4) Should I use antibiotic eye drops for pink eye from Zika?
No—viral conjunctivitis doesn’t respond to antibiotics; they’re reserved for clear bacterial superinfection. AAO

5) Are steroid eye drops safe?
They can be vision-saving for uveitis, but must be prescribed and monitored by an ophthalmologist due to side effects like high eye pressure. EyeWiki

6) Can I take ibuprofen for fever?
Wait until a clinician rules out dengue; otherwise use acetaminophen first. CDC

7) How could my baby’s eyes be affected?
Infants with congenital Zika exposure may have macular scars, pigment changes, or optic-nerve abnormalities and need early eye exams and vision therapy. AAO

8) Do I need to stop contact lenses?
Yes—pause while eyes are red/irritated to protect the cornea.

9) Can Zika spread via tears?
Transmission is mainly mosquitoes and sex; standard hygiene with eye secretions is still wise.

10) When can I return to work/school?
After fever resolves and you feel well; practice cough/hand hygiene and avoid rubbing eyes.

11) Could Zika cause glaucoma or cataract?
Not directly, but uveitis and steroid treatment can raise pressure or induce cataract—hence close follow-up. EyeWiki

12) Are biologics like adalimumab ever used?
Only for severe non-infectious uveitis that threatens sight; not for the virus itself. PMC

13) Is strabismus surgery helpful for children with congenital Zika syndrome?
It may improve alignment and function in selected cases. PMC

14) What eye tests might my doctor do?
Slit-lamp exam, intraocular pressure, dilated fundus exam, OCT, and photos—chosen by findings. PMC

15) What’s the single most important prevention tip?
Avoid mosquito bites (repellent, clothing, eliminating standing water) and use condoms to prevent sexual transmission. CDC+1

Disclaimer: Each person’s journey is unique, treatment plan, life style, food habit, hormonal condition, immune system, chronic disease condition, geological location, weather and previous medical  history is also unique. So always seek the best advice from a qualified medical professional or health care provider before trying any treatments to ensure to find out the best plan for you. This guide is for general information and educational purposes only. Regular check-ups and awareness can help to manage and prevent complications associated with these diseases conditions. If you or someone are suffering from this disease condition bookmark this website or share with someone who might find it useful! Boost your knowledge and stay ahead in your health journey. We always try to ensure that the content is regularly updated to reflect the latest medical research and treatment options. Thank you for giving your valuable time to read the article.

The article is written by Team RxHarun and reviewed by the Rx Editorial Board Members

Last Updated: August 30, 2025.