Geoff Lindsay

Ankylosing Spondylitis affecting your eyes?

Pain in the eye? Got AS? 

It could be Acute Anterior Uveitis (AAU)

In this blog, you’ll learn about AS and Acute Anterior Uveitis, (AAU for short), and how yoga might be able to help.  

My experience of Uveitis/ Iritis:

It used to be called Iritis. My first bout of Iritis was in 1981, and many many times since. But I was not diagnosed with AS till 2009. I’ve had symptoms of AS for 50 years this year. 

For me, stress is a cause, as was smoking. 


The frequency of attacks was higher with the inflammation and fusion that has happened in my neck from about 1980 onwards. 

Uveitis risk factors

Risk of acute outbreak of uveitis is increased among people with AS who have significant changes of the cervical spine (the neck).

But that doesn't mean that if you stretch the neck that this may help you with your AAU. 


2 in 5 of us get AAU at some time in our life. It’s a serious matter for a lot of us. 


Uveitis can cause the most serious sight damage. 

Download the NASS Guide to Uveitis here 

This is what I've learned from hard earned experience of just about 50 years living with AS and Iritis/Uveitis/AAU: 

Go to A&E or local Eye Hospital immediately if you have a red, bloodshot eye and if it feels like dirt in your eye that is hurting. Uveitis, especially in the acute phase, is a very serious sight-threatening condition. In the acute phase you may also get photophobia, extreme sensitivity to light. 

For more information on the symptoms and actions to take for Uveitis please read the NASS Guide to Uveitis


If it’s you or someone you know, and they are not diagnosed with AS, but are diagnosed with Uveitis, then ask about possible diagnosis of AS/axSpA. 


Stop smoking tobacco. Frequency of acute outbreaks has been much reduced since I stopped smoking. Yoga is living your best life, not just the yoga poses.  

I’ve heard people say smoking is their only pleasure left. Well, Is being able to see a pleasure for you? “Mr Lindsay, Where are you going to get another eyeball from?”

This is a genuine quote from a Doctor treating my first outbreak of AAU. 

Several research studies have concluded that tobacco smoking is a significant risk factor for uveitis. Smoking can increase your risk of an attack of uveitis. If you smoke do consider getting help to quit.


A Professor of Ophthalmology told me, when I was being treated for yet another outbreak of iritis, that the best boost to the immune system is fresh air. 


Yoga don'ts during a Uveitis flare


Don't do inversions, upside down yoga poses, when you have acute anterior uveitis/iritis because they increase the pressure in your eye. You don't want that. 


Don’t do headstand and plough pose. Even shoulderstand may be too much. I used to do these but don't now that I know I have fusion in my neck. In recovery and when stable, you may find standing forward bend (flexion), uttanasana in the ancient language of yoga, may actually help by decompressing the spine. Headstand compresses the spine. I don’t advise headstands at all for people with AS.


What yoga can you do safely during a Uveitis flare?


There is little research on exercise/stretching/yoga for uveitis.


If you are going through probably years of your neck getting worse, do practise safe yoga modified for your individual AS, for your whole body.


You need to rest during an acute phase of Uveitis and to rest in the recovery period, which can be weeks. So think about relaxing yoga like NSDR, which you can find here

Below are 4 poses you can do during a Uveitis flare:

Man doing gentle yoga during a Uveitis flare


For detail on each of these poses and more information on AAU.
Watch the video below: Yoga for when your eyes are in flare of
Acute Anterior Uveitis

Yoga may help generally


Nobody knows the cause of iritis, but for me the times of high stress, like at work, correlate with outbreaks of iritis. So relaxing restorative yoga when in flare and in recovery, NSDR/ yoga nidra, breathwork (pranayama). Yoga can help you to help yourself. 

It may be, that stretching the neck helps in Uveitis, but I emphasise that this is only my experience over 40 years that I am trying to apply. Decompressing the neck by lengthening the neck is the idea, but only when stable and free of AAU completely, after you have completely recovered from the acute phase. 


Risk of acute outbreak of Uveitis is increased among people with AS who have significant changes of the cervical spine, the neck. But that doesn't mean that if you stretch the neck that this may help prevent AAU. There is a correlation but that may not be a causal relationship between fusion in the neck and AAU.


Just one practical tip on Uveitis

Wear dark glasses during the acute phase, especially if you are super sensitive to light. They can can help avoid sudden exposure to light. Go to an optician and ask about Grade 4 sunglasses. They are extra dark and help to protect your eyes during AAU.


When AAU is stable and you would like to practice Yoga for AS, you can explore a Live Online Class or the Virtual Library.


Both of which you can try for free below.


References

Managing My Uveitis, https://nass.co.uk/about-as/what-is-as/your-eyes, Accessed 23rd February 2023

Uveitis and Ankylosing Spondylitis, https://nass.co.uk/wp-content/uploads/2018/08/Uveitis-factsheet-2015.pdf, Accessed 23rd February 2023

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