Presumed Ocular Histoplasmosis Syndrome (POHS)

What is Presumed Ocular Histoplasmosis Syndrome (POHS)?

Presumed Ocular Histoplasmosis Syndrome (POHS) is a critical condition of the eye linked to a fungal infection known as Histoplasma Capsulatum, which is primarily found in soil contaminated with bird or bat droppings which though doesn’t directly involve active fungal infection in the eye, it is presumed to be associated with a past disease of the individual. Such a type of condition mainly affects the choroid, the layer of blood vessels just behind the retina, and is found to result in serious vision problems, including blindness or total loss of eyesight.

What are the symptoms of Presumed Ocular Histoplasmosis Syndrome?

Most people with POHS are asymptomatic in the early stages of the disease but it can yet erupt and develop following symptoms to the affected people:-

Blurred vision
Loss of central vision
Distorted vision (straight lines may appear wavy)
Dark spots or blind spots in the central visual field

These symptoms are primarily caused by the development of choroidal Neovascularization (CNV), where abnormal blood vessels from beneath the retina, potentially leading to scarring and vision loss.

What causes POHS?

The POHS, believed to result usually from exposure to Histoplasma Capsulatum, a fungus found in certain geographical regions like the Mississippi and Ohio River valleys, usually does not affect the eyes at the initial stage, but the fungus can yet leave scars in the choroid which with time, lead to CNV, causing vision impairment and other risk factors:-

Living in areas where Histoplasmosis is endemic
A history of exposure to bird or bat droppings
Compromised immune systems

How is POHS diagnosed?

Following are the diagnostic tools used to diagnose POHS through a comprehensive eye examination by an ophthalmologist:-

Fundoscopy – Provides the detail of histo spots/scarring in the retina for POHS.
Fluorescein Angiography – In this test a special dye is injected into a vein of the patient to visualize blood vessels in the retina to see growth or development of blood vessel.
OCT – Optical Coherence Tomography helps monitor retina, detect CNV, and measure retinal thickness of the patient.

What treatments are available for POHS?

Following are the treatment options for POHS that focus on managing the complications of the disease, especially choroidal Neovascularization:-

Anti-VEGF injections – Ranibizumab or Bevacizumab injections are used to inhibit the growth of abnormal blood vessels and reduce swelling of the eye.
Laser Photocoagulation – Such treatment destroys abnormal blood vessels and prevents further damage.
Photodynamic therapy (PDT) – This treatment combines a light-activated drug and a low-power laser to target abnormal blood vessels while minimizing damage to surrounding healthy tissue.

Regular monitoring is essential to manage CNV effectively and to prevent vision loss.

Can POHS be prevented?

Currently, there is no surefire way to prevent POHS, but preventing exposure of individuals to Histoplasma Capsulatum by avoiding areas with bird or bat droppings has been found to lower the risk of infection. For those who live in endemic areas, regular eye exams can help detect early changes related to POHS and prevent vision loss through timely treatment.

What is the prognosis for POHS?

The prognosis for POHS varies and so in most cases, people with POHS do not experience vision problems, but in some individuals, CNV can yet lead to severe vision impairment if not promptly treated by the doctors. Hence, diagnosis and treatment of CNV are indispensable to stabilize and improve vision in certain cases for which long-term monitoring is important to detect and check any recurrence or progression in the individuals susceptible to the condition.

How can individuals live with POHS?

Living with POHS requires regular eye check-ups and prompt treatment if symptoms of CNV appear. Since vision loss can impact daily life, people with advanced POHS may need to adapt by using visual aids or low-vision services. Maintaining a healthy lifestyle and following through with medical advice can help manage the condition effectively.

Why Choose Tender Palm Eye Hospital for Presumed Ocular Histoplasmosis Syndrome (POHS) Treatment in Lucknow, India?

Tender Palm Eye Hospital is one of the leading eye care and treatment centers in Lucknow, offering specialized diagnosis and management of Presumed Ocular Histoplasmosis Syndrome (POHS) – a rare eye condition linked to a previous fungal infection that can lead to serious vision loss if left untreated.

Our experienced ophthalmologists use advanced imaging techniques such as Fluorescein angiography and optical coherence tomography (OCT) to detect characteristic lesions and signs of choroidal Neovascularization. We provide personalized treatment plans, including anti-VEGF injections and close monitoring, to preserve central vision and prevent disease progression. Our focus is on early detection, expert care, and lifelong vision health.