Ask the KD Experts: Kawasaki Disease and Vision Loss

Question:

I wanted to ask if you could please provide some feedback on vision loss due to KD. There’s been a story surfacing these past few days of a blind Paralympian who lost his vision to KD as a child. A link was shared on the KDF’s social media platforms and several parents were shocked to hear that vision loss was a result of KD.

Thank you,

Veronica

 

Answer:

Dear Veronica,

KD causes inflammation in the anterior chamber of the eye. This is the fluid-filled space that is behind the cornea (clear cap that covers the pupil, the black central part of the eye) but in front of the lens. This space is lined with endothelial cells, the same cells that line the arteries of the heart and other blood vessels. The inflammation in the anterior chamber is mediated by cells from the blood and infiltrate into this space causing a condition called “anterior uveitis”. The cells can be seen by an eye specialist using a special instrument called a slit lamp. There should be no cells floating in this space under normal conditions. In acute KD, more than 80% of patients will have at least a few cells in the anterior chamber. If the inflammation is more severe, then scarring can occur that blocks the flow of fluid into and out of this space. This kind of scarring is very rare. However, any child with KD who has prolonged bloodshot eyes after IVIG treatment should be evaluated by an eye specialist. If severe inflammation is not treated and scarring occurs, then pressure can build up in this space causing a condition called glaucoma. If not treated, the pressure could damage the eye and even lead to blindness. This is apparently what happened to the athlete. This is the only case of blindness resulting from KD that I have heard. Whether or not there were other eye disease problems in this individual unrelated to KD is not known to me.

Sincerely,

Jane C. Burns, M.D.
Professor and Director, Kawasaki Disease Research Center
Dept. of Pediatrics MC 0641
UCSD School of Medicine
9500 Gilman Dr.
La Jolla, CA 92093-0641