James Joyce and Chronic Uveitis

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James Joyce (1882-1941) was an Irish avant-garde novelist and poet who suffered from intractable uveitis (inflammation of the eyes).  Here’s Harvard lecturer Kevin Birmingham’s blog post on Joyce and his medical problems:

In 1917, while walking down a street in Zurich, James Joyce suffered an “eye attack” and remained frozen in agony for twenty minutes. Lingering pain left him unable to read or write for weeks. Joyce had endured at least two previous attacks, and after the third he allowed a surgeon to cut away a piece of his right iris in order to relieve ocular pressure. Nora Barnacle, Joyce’s partner, wrote to Ezra Pound that following the procedure Joyce’s right eye bled for days.

Joyce was suffering from a case of glaucoma brought on by acute anterior uveitis, an inflammation of his iris. It was, unfortunately, nothing new. Joyce’s first recorded bout of uveitis was in 1907, when he was twenty-five years old, and the attacks recurred for more than twenty years. To save his vision, Joyce had about a dozen eye surgeries (iridectomies, sphincterectomies, capsulectomies) — every one of them performed without general anesthetic. He lay in dark rooms for days or weeks at a time, and his post-surgical eye patches became his trademark. Doctors applied leeches to siphon blood from his eyes. They gave him atropine and scopolamine, which cause hallucinations and anxiety, to dilate his pupils. They administered vapor baths, sweating powders, cold and hot compresses, endocrine treatment and iodine injections. They prescribed special diets (oatmeal and leafy vegetables) and warmer climates. They disinfected his eyes with silver nitrate, salicylic acid, and boric acid; instilled them with dionine to dissipate nebulae; and doused them with cocaine to numb the pain. Nothing really helped.

Uveitis raises intraocular pressure and produces a sticky exudate, which caused Joyce’s irises to attach to the lenses behind them. Sometimes the exudate was so thick that it congealed and blocked his pupil altogether — his future publisher Sylvia Beach remembered seeing his eye “covered by a sort of opaque curtain.” The increased pressure caused glaucoma, which eroded his optic nerve over the years, making his vision spotted, narrow, and dim.

By the age of forty-eight, Joyce’s left eye functioned at only one-eight-hundredth the normal capacity and his “good” eye at one-thirtieth. His eyeglasses prescription was +17 in both eyes — severely farsighted. One of the twentieth century’s great novelists often required a magnifying glass to read anyone’s writing, including his own. Each new attack brought him a step closer to blindness, and the consequent threat to his literary career contributed to a series of nervous breakdowns.

Joyce lived a thoroughly documented life, but the cause of his lifelong battle with uveitis has never been definitively named.

Among the many possible causes of chronic uveitis are syphilis, sarcoidosis, and tuberculosis.  What do we know about James Joyce’s uveitis?  Read more about it here.