I have lost my sight,” Sir Elton John revealed this weekend while attending a performance of the new musical The Devil Wears Prada in London’s West End.
Five months after developing an infection in his right eye, the legendary singer-songwriter says he can no longer see.
And because the other eye ‘isn’t the best’, he is effectively blind.
Although it is hoped that vision in his ‘good eye’ will eventually return, he has been unable to work for several months.
Sir Elton, 77, recently told ABC News Good Morning America: ‘I can’t see anything. I can’t read anything. I can’t watch anything… (but) there’s hope and encouragement that things will work out.”
It’s the kind of story that will have alarmed many.
Every day, 250 people in Britain begin to lose their sight, equivalent to one person every six minutes, but only a small proportion is due to infections, says Mike Burdon, consultant ophthalmologist at Bishop Auckland Hospital, County Durham.
‘It sounds like he (Sir Elton) has been very unlucky because most eye infections are temporary and don’t cause long-term vision problems,’ says Mr Burdon. ‘In fact, it is rare for an infection to lead to blindness.
Sir Elton John, 77, revealed this weekend that he has lost the sight in his right eye
‘One possibility is that he may have been struck by a severe case of keratitis, an infection that attacks the cornea and clear dome in front of the eye, causing blurred vision.
‘This is extremely painful, like a toothache in the eye, and possibly sight-threatening.’
The condition is caused by bacteria, viruses or, more rarely, fungal infections or infections transmitted by contaminated water, says Melanie Corbett, an ophthalmologist and eye surgeon at Western Eye Hospital, which is part of Imperial College Healthcare NHS Trust.
Keratitis is also more likely if you have blepharitis: an inflammation of the eyelid margin caused by bacteria, making it crusty and painful.
‘Blepharitis can affect more than half of the adult population, although many people don’t know they have it,’ says Ms Corbett. She warns that the treatments recommended by some opticians – wiping the affected area with wipes and solutions containing chemicals such as alcohol – can actually worsen the situation by damaging the corneal surface.
“Remove dirt only with a clean washcloth and hot water,” she says.
The usual route for any infection-causing bug is by rubbing the eyes and the most common type of eye infection is conjunctivitis.
It is caused by bacteria, viruses or allergies and is characterized by inflammation in the tissue lining the front of the eye and the inner eyelid. You develop red, gritty eyes that are inflamed and sticky.
Keratitis, which specifically affects the cornea, is much more serious. In England alone, more than 2,700 people are admitted to hospital every year with a suspected corneal infection caused by keratitis. Ms Corbett says most people are given an intensive treatment plan to try to reduce the infection as quickly as possible.
This is because the surface of the cornea is usually damaged in some way (for example, as a result of wearing contact lenses), making it more porous to infections. Healthy people with healthy eyes don’t get keratitis.’
Every day 250 people in Britain start to lose their sight, equivalent to one person every six minutes, but only a small proportion are due to infections
It is more common in people who wear contact lenses and also in people with reduced immunity due to illness or medications.
Treatment depends on the cause of the infection. If bacteria have entered the cornea, they can begin to destroy the cells of the surface layer (the epithelium) and ‘melt through’ through the deeper level, perforating the eyeball.
‘The hole causes the aqueous humor (the jelly that gives the eyeball its shape) to leak out of the hole and must be repaired surgically. I currently perform approximately one of these critical surgeries per month at Western Eye Hospital.”
The first-line treatment consists of antibiotic eye drops to be applied every hour, day and night, for at least 48 hours and the entire treatment plan takes several weeks, says Ms Corbett.
Severe scarring of the cornea can cause lifelong vision loss. But in most cases it can be treated successfully over time and the cornea heals, returning vision.
Viral keratitis, which can be caused by the cold or flu virus or the herpes simplex virus (which causes cold sores), can also affect vision, but in a different way, as white spots form on the surface of the cornea.
‘Viral keratitis is much less likely to cause long-term vision loss, and although antiviral tablets or ointments can help, many people get better without treatment,’ says Ms Corbett.
Even simple infections can cause vision loss, depending on which part of the eye is affected.
Some people are more likely to develop all kinds of eye infections.
Contact lens wearers are at greater risk because they regularly put foreign objects in their eyes. According to Moorfields Eye Hospital in London: ‘About one in 3,000 people will develop a serious corneal infection each year from wearing contact lenses and some of these patients will require a corneal transplant.’
A specific risk is acanthamoeba keratitis, a condition that can cause severe pain, extreme sensitivity to light and, in at least a quarter of cases, blindness.
Acanthamoeba is a microscopic parasite found in soil and water, including tap water.
It can get into the eyes through gardening, but the main cause is water containing the parasite becoming trapped between the cornea and the contact lens. The parasite can then eat into the cornea.
This is why contact lens wearers are warned to remove their lenses before swimming and showering, and not to wash lenses with water.
Injury to the eyes can also increase the risk of infection, so you should wear goggles when exercising, Mr Burdon suggests.
“Participating in sports or recreational activities without proper eye protection increases the risk of eye injury from debris, projectiles or accidental impacts,” he says. ‘Wearing protective eyewear, such as goggles, is essential to prevent potential damage.’