How eye infections can reduce vision: The example of Elton John

As the British singer himself revealed, he has been struggling to regain his sight since last July. There is some improvement, Elton John added, but it’s very slow, and he’s struggling. But he’s doing the best he can, under the current circumstances.

But how can an eye infection threaten vision? The answer it depends on the cause and how quickly the patient addresses the doctor, reports Dr. Anastasios-I. Kanellopoulos, MD, Surgeon-Ophthalmologist, founder and scientific director of the LaserVision Ophthalmology Institute, professor of Ophthalmology at New York University.

“Infections develop when they enter and begin to grow in the eye bacteria, viruses, fungi or parasites. This can happen if there is an injury or abrasion to the eye, or if it is exposed to contaminated water, dust or hands. It can also occur from contact lenses that are not properly maintained or that do not fit the eye, as well as the spread, through the blood, of germs from other parts of the body,” he explains.

Infections can develop in any part of the eye, both externally on the cornea or conjunctiva, and inside the eyeball. The symptoms that will develop vary, depending on the underlying cause of the infection. The most common are pain and eye redness, sensitivity to light, blurred vision, itching or burning sensation, tearing or thick discharge, swelling and redness of the eyelids.

“If any of these develop, it is essential that the patient contact their ophthalmologist immediately. It can be something simple like conjunctivitis that can be treated relatively easily, or something serious like endophthalmitis that needs immediate treatment, otherwise it can lead to permanent vision loss or even blindness,” emphasizes the professor.

The most common eye infection is conjunctivitiswhich is often caused by the same viruses that cause the common cold. Conjunctivitis leads to eye redness and discharge, while it is very contagious. Sometimes it is caused by bacteria, so antibiotic treatment may be needed to fight it. Conjunctivitis can of course also be allergic, but in such a case it is not considered an infection.

Other common eye infections are:

• OR keratitis, i.e. inflammation of the cornea of ​​the eye, which can lead to an ulcer (sore) in it
• OR endophthalmitis, a painful infection inside the eye
• OR cellulite of eye socket, a bacterial infection of the tissues behind and around the eyeball
• The eye infections causing sexually transmitted diseases (herpes, syphilis, gonorrhoea, acute warts, adolescent lice, HIV/AIDS infection)

“Endophthalmitis is one from the most serious infections tissues or eye fluids. It is an emergency because if not treated immediately, it can lead to blindness. It can be exogenous or endogenous. In extrinsic, bacteria or fungi invade the inside of the eye after an operation, an injection into the eye or an injury. In endogenous, an infection spreads to the eye from another part of the body (e.g. a urinary tract infection),” explains Mr. Kanellopoulos.

The most common symptoms of endophthalmitis that should prompt sufferers to see a doctor are worsening eye pain after eye surgery or injury, white or yellow pus or discharge, eyelid edema (swelling), and decreased or blurred vision.

OR cellulitis of the eye socket is a painful infection caused by bacteria or fungi that can spread quickly. Sometimes it develops after an insect bite or is due to the spread of bacteria from other areas of the body (eg from the sinuses or from an abscess in the teeth). If not treated promptly and properly it can progress quickly and lead to vision loss and other serious complications. When cellulitis is located deep inside the eye (behind the septum of the eye socket) it can be life threatening. In such a case, hospitalization may be required to be treated.

Similarly, the herpes simplex virus can infect the cornea, leading to fibrosis (growth of scar tissue) and decreased vision.

“Infections such as keratitis and endophthalmitis can damage the cornea, retina or other delicate structures of the eye. Without prompt and proper treatment, the inflammation that develops causes tissue damage and the development of scar tissue. These changes can be irreversible, leading to a partial or even complete loss of vision”, underlines Mr. Kanellopoulos.

Although it is not known exactly what happened to Elton John, “his case highlights the importance of early diagnosis and treatment. Otherwise there is a risk of serious and dangerous complications,” he concludes.