Advancements in antiretroviral therapy have changed the way we view and treat cytomegalovirus retinitis (CMVR). At one time the diagnosis of CMVR necessitated that most patients undergo daily intravenous infusions of anti-CMV agents. Today, after the restoration of their immune systems, they are able to stop maintenance anti-CMV therapy. HAART failure, resistant strains of CMV, and immune recovery uveitis are growing challenges.