Your Questions (2011)

Your questions and comments about any aspect of your eye health not covered in this website are most welcome. To submit your question or comment, please click here.

August 2011

Nicki from Herts, United Kingdom, comments:
Hi, my daughter was diagnosed with bilateral anterior uveitis 2 years ago. Her condition was chronic and sight threatening and she is now blind in one eye. At the time there was little info or support in the UK which led to the creation of "Olivia's Vision" a charity supporting uveitis sufferers and their families. We have an informative website, forum for adult and paediatric sufferers and their families, and a Helpline. Our medical advisory board (Prof Murray - Birmingham, Prof Dick - Bristol, and Prof Ayliffe - London) help us direct raised funds to help as many sufferers as possible. Please visit our website: www.oliviasvision.org

Brian replies:
Dear Nicki, thank you for your message. I think the work that Olivia's Vision has done with uveitis has been fantastic, so please keep up the great work! Olivia's Vision deserves all the help it can get!

June 2011

Herb and Vivian from Roswell, United States, asks:
Dear Brian, could you please let us know if there is any information about blindness, temporary or permanent, as a result of low blood count? Thank you.

Brian replies:
Dear Herbert and Vivian, thank you for your enquiry. I guess the first thing is to know the type of blood cell that is low: low red blood count (anemia), low white blood count (leucopenia) or low platelet count (thrombocytopenia).

In low red blood count (anemia), there will be less red blood cells to carry nutrients and oxygen to the cells in your eye. Generally, if the anemia is mild, there should not be any effect on your vision. If severe and prolonged, it can cause visual impairment due to ischemic damage to the optic nerve (neuropathy) and retina (retinopathy), especially if not reversed in a timely fashion. When the retina and optic nerve become starved of oxygen and nutrients over the longer term, their ability to function decreases and this is why visual impairment occurs. One situation of this is in people who abuse alcohol, resulting in chronic vitamin B and folate deficiency anemia - visual impairment resulting from this is sometimes called nutritional amblyopia or toxic alcohol-tobacco amblyopia (not to be confused with childhood amblyopia). Damage to the optic nerve can also happen when there is a sudden drop in red blood count such as during severe trauma or complex surgery requiring a blood transfusion. Anemia affects the whole body including the brain, so if your visual cortex is affected, then your vision will also be impaired.

In low white blood count (leucopenia), especially if longstanding, your body and your eye will not be able to mount an effective immune response against any viral or bacterial infection. The risk of severe ocular infections and resultant visual impairment increases due to this. An extreme example of this would be someone with HIV infection, who can develop severe herpetic infections of the eye. Even when you are generally a bit run down, your immune system can be depressed and you find that you may suffer from mild viral conjunctivitis more easily. Low white blood count is a risk factor for postoperative infective endophthalmitis (severe infection after surgery), so make sure you inform your ophthalmologist before you undergo any eye surgery. This way, your ophthalmologist can take extra precautions to further reduce the risk of infection after surgery.

Finally, low platelet count (thrombocytopenia) causes you to bleed more easily. Your blood is less able to clot when you are cut or injured. This may be seen as a good thing because you will be at less risk of blood clots within your blood vessels (causing deep venous thrombosis or heart attacks). However, if the ability of your blood to clot is reduced by too much, you will find that you bruise and bleed very very easily. This can result in life-threatening blood loss from a bleeding stomach ulcer or injury or surgery. Thrombocytopenia is often accompanied by anemia and leucopenia.

Disclaimer: Replies to your questions are only general in nature, and in no way are to be considered as replacement for a proper ophthalmology consultation and examination. If you require a more specific evaluation, please consult your ophthalmologist for a full eye examination.

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