Ocular manifestations of chronic kidney disease among adult patients receiving hemodialysis

The loss of an organ is a devastating event. The potential of visual loss is a reality a patient with chronic kidney disease has to live with. It is interesting to note that many patients are weighed down by their present diagnosis, and resources, financial and otherwise are directed toward this condition to the exclusion of others. A patient may therefore not notice or complain of visual symptoms until vision is irreversibly lost. At another end of the spectrum is an undiagnosed case of chronic kidney disease, with its ocular manifestations, presenting first to an ophthalmologist. Visual loss can occur from the primary cause of the disease, renal insufficiency and its complications and renal replacement therapy (hemodialysis or renal transplant). The focus in the management of chronic kidney disease has shifted from treatment-only to prevention and delay of progression, with a view of increasing life expectancy and quality of life. This should also include ocular health as the onset and progression of potentially vision-threatening conditions can have great implications in the everyday life of a patient with chronic kidney disease. This special report aims to highlight the importance of ocular examination in this group of patients so that necessary counseling can be given and treatment instituted, when indicated, before irreversible visual impairment occurs.