POHS is rare. Most people infected with the histo fungus will never develop the infection in their eyes. However, if you are diagnosed with histoplasmosis, be alert for any changes in your vision. While rare, the disease has affected up to 90% of the adult population in a region of the US known as the “Histo Belt.”

Because the histo spots themselves usually do not cause symptoms, patients typically do not develop symptoms until neovascularization grows in the central macula. Symptoms include painless progressive blurring of central vision and wavy vision (metamorphosia), which can be sudden or develop slowly.

What Treatment Is Available for Ocular Histoplasmosis? There are no eye drops or antibiotics known to be effective in ocular histoplasmosis. Most cases of ocular histoplasmosis are treated with medications known as antibodies to vascular endothelial growth factor (Anti-VEGF).

Presumed Ocular Histoplasmosis Syndrome (POHS) Histoplasmosis is caused by a fungus that can make you sick if you inhale it. In some people, the fungus spreads to the eyes. When this happens, abnormal blood vessels form, which can affect your vision. Without treatment, vision loss can become permanent.

OHS usually doesn’t cause any symptoms in the early stages. But over time, you may notice: Straight lines looking crooked or wavy. Blind spots in your vision.

The veteran’s disability, ocular histoplasmosis, bilateral, is currently rated under Diagnostic Code 6006 for retinitis as the most closely analogous disability. Retinitis is rated from 10 percent to 100 percent based on impairment of visual acuity.

For most people, the symptoms of histoplasmosis will go away within a few weeks to a month. However, some people have symptoms that last longer than this, especially if the infection becomes severe.

One study found that the rate of POHS among people with private health insurance was 13 cases per 100,000 people in 2014 (map). This study also showed that 1 in 4 people with POHS had choroidal neovascularization (new blood vessels inside the eye that can cause vision loss).

Histoplasmosis is an infectious disease caused by inhaling the spores of a fungus called Histoplasma capsulatum. Histoplasmosis is not contagious; it cannot be transmitted from an infected person or animal to someone else.

Presumed Ocular Histoplasmosis Syndrome. (POHS) causes atrophy (wasting) around the optic nerve and multiple scars, called histo spots, in the choroid. These symptoms are accompanied by new blood vessel growth (neovascularization) that starts adjacent to a histo spot.

However, injections of medications that inhibit neovascularization are recommended. These medications include bevacizumab (Avastin® ), ranibizumab (Lucentis® ) and aflibercept (Eylea® ).

SD-OCT is used to observe the disease course. When PPA and/or histo spots are present, the normal hyperreflective bands appear disorganized. Histo spots also appear as focal areas of outer retinal atrophy. Fundus autofluorescence.

However, a study in the Netherlands found that all patients with clinical POHS were histoplasmin skin antigen test negative. POHS is different from “Disseminated Histoplasmosis” which is the exudative/productive H. capsulatum infection of ocular tissues, seen in immunocompromised adults or infants.