The diagnosis of ocular manifestations of IRIS requires a high level of suspicion. In addition to signs of retinitis, inflammatory symptoms include vitritis, papillitis, and macular edema, resulting in symptoms of loss of visual acuity and floaters in affected eyes. Treatment of IRIS associated CMV retinitis and IRV may involve anti-CMV therapy with gancyclovir or valgancyclovir [17, 65] . However, the occurrence of IRU in patients receiving anti-CMV therapy draws its use into question [64, 66, 67] . The use of systemic corticosteroids has been successful, and IRV may require periocular corticosteroid injections [61, [68] [69] [70] . Due to its significant morbidity and varying temporal presentations, clinicians should maintain a high level of vigilance for ocular manifestations of CMV-associated IRIS.