Miami Herald - Friday, August 16, 1985
Cristine Russell

The discovery is the first evidence that the virus is found in eye fluid, and it raises new questions about whether infection could be transmitted through direct contact with the tears of AIDS victims, particularly by eye doctors and their patients, as well as through contact with the medical instruments used in eye examinations.

There is no evidence that such transmission has ever taken place, and the chances of it occurring are extremely slight, said scientists from the National Eye Institute, the National Cancer Institute and NIH's Clinical Center.

The virus is fragile and does not survive well outside the body fluids, scientists have found.

But sources familiar with the new findings suggest that transmission of the HTLV-III virus -- the virus found to cause acquired immune deficiency syndrome as well as other illnesses -- could, in theory, occur through repeated contact with the tears of AIDS patients or others carrying the virus.

Finding the virus in tears is significant in understanding the disease, said Dr. Robert Gallo, head of NCI's laboratory of tumor-cell biology. "It indicates that it is present increasingly in more body fluids than we or anybody else originally thought. It has been found not only in blood cells and lymph nodes, but also free in the blood plasma, in semen, saliva and now tears," he said.

Because frequent contact with tears occurs during eye examinations, government physicians are preparing recommendations urging that precautions be taken to minimize direct contact with the tears of AIDS patients, including contact during routine medical procedures such as testing for glaucoma and fitting soft contact lenses.

Such precautions might include the use of gloves by medical personnel during eye examinations and using bleach to sterilize equipment used to examine these patients' eyes.

The findings from the study have not been publicized, but have quietly begun to circulate in medical and government circles. A scientific paper has been submitted to the British medical journal Lancet by several authors, including Dr. Leslie Fujikawa of the eye institute's clinical branch and Dr. S. Zaki Salahuddin of NCI's laboratory of tumor-cell biology.

Dr. Carl Kupfer, director of the National Eye Institute, declined to comment on the findings Thursday, saying, "I think it's vitally important that the professionals have this information before the lay public has it."

A key question is whether precautions should be taken in treating only for known AIDS patients, those with symptoms of a less severe form of the disease known as AIDS-related complex, those at risk of getting the disease or all patients.

"We haven't made an official recommendation yet," said researcher Fujikawa. "My feeling is that until we know more, it's better to be safe than sorry. I believe precautions should be taken. . . . At the moment, we're mainly concentrating on patients that we know or suspect may be at risk for AIDS."
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