The ocular manifestations include anterior chamber and vitreous inflammation with high intraocular pressure, retinal hemorrhage, retinal vasculitis, retinal vascular occlusion, retinitis, neuroretinitis, serous retinal detachments, and choroiditis.
Dr. Cunningham described a case of Chikungunya with focal areas of retinitis, such as are seen sometimes in patients with necrotizing retinitis due to syphilis or herpes virus infection. The patients tend to have panuveitis.
Because these mosquito-borne diseases can have similar appearances upon presentation, Dengue fever may be hard to differentiate from Chikungunya. He advised placing the diseases in the context of their endemic areas, areas of patient travel, and the systemic symptoms.
"Hemorrhages would suggest that the patient has Dengue fever, and profound arthritis suggests Chikungunya if the patients have been to areas that have those disorders," Dr. Cunningham said. "If they have been to South America, the chances of them having contracted Chikungunya are much lower."