Eales Disease: Understanding This Rare Inflammatory Eye Condition

Eales Disease: A Rare Retinal Vasculitis Causing Vision Loss

Imagine being in your twenties or thirties—healthy, active, and thriving—when suddenly, floaters or vision loss appear in one eye. For some, this is the first sign of Retinal Vasculitis, a rare yet serious retinal condition that can lead to lasting visual damage if not promptly diagnosed and treated.

At South Bay Retina, Dr. Keshav Narain and his team specialize in recognizing and managing uncommon retinal diseases like Eales, combining advanced diagnostics with cutting-edge treatment tailored to each patient.

Eerie red lighting intensifies the wide-eyed gaze, evoking a sense of urgency and panic.

What Is Eales Disease?

Eales Disease is a rare, idiopathic inflammatory vasculitis that primarily affects the mid-peripheral retinal veins. It is marked by:

• Recurrent vitreous hemorrhage (bleeding in the back of the eye)

• Retinal ischemia (blocked blood vessels)

• Neovascularization (growth of fragile, abnormal new vessels)

• Retinal detachment if untreated

It primarily affects young adult males and often involves both eyes. While the exact cause remains unknown, many cases are linked to an abnormal immune response—often triggered by exposure to tuberculosis (TB) proteins, even in the absence of active TB infection.

Symptoms to Watch For

Because Eales Disease develops silently and progresses in phases, symptoms may come and go, making early detection difficult. Patients often report:

• Sudden floaters

• Blurred or distorted vision

• Intermittent vision loss

• In severe cases, complete vision blockage due to bleeding

These signs should never be ignored, especially in otherwise healthy young adults.

What Causes Eales Disease?

While still under investigation, key contributing factors include:

• Immune hypersensitivity to TB proteins

• Latent TB infection (even without active disease)

• Elevated inflammatory markers in the blood

• Possible genetic predisposition or prior infections

  
  

How Is It Diagnosed?

At South Bay Retina, Dr. Narain conducts a comprehensive, step-by-step evaluation to ensure accurate diagnosis:

• Dilated Eye Exam – to detect retinal hemorrhages and abnormal vessel growth

• Fluorescein Angiography (FA) – to map areas of poor circulation and neovascularization

• Optical Coherence Tomography (OCT) – to assess macular swelling or retinal traction

• TB Screening – including Quantiferon-TB Gold or Mantoux skin test

• Systemic Lab Workup – to rule out other inflammatory or infectious causes

  
  

Treatment Options at South Bay Retina

Our treatment goal is to reduce inflammation, stop bleeding, and prevent recurrence:

• Corticosteroids – to control retinal inflammation

• Anti-TB Therapy – if latent TB is suspected or confirmed

• Anti-VEGF Injections – to block abnormal blood vessel growth

• Subthreshold 532nm Focal Grid Laser – targets ischemic retina with minimal damage

• Vitrectomy Surgery – for non-clearing hemorrhage or retinal detachment

  
  

The South Bay Retina Protocol

Dr. Narain’s approach is evidence-based and patient-specific, focused on preserving vision and preventing long-term damage. Key elements include:

• Early Detection – using advanced imaging and functional tests

• Combination Therapy – tailored mix of laser, injections, and systemic treatment

• Close Monitoring – to detect recurrence or macular involvement early

• Lifestyle Counseling – to reduce systemic triggers or TB reactivation

Monitoring for Ethambutol Toxicity

In cases where anti-TB treatment is required, a serious concern is optic nerve toxicity from the drug ethambutol. At South Bay Retina, we proactively screen for this risk using Visual Evoked Potentials (VEP)—the gold standard for detecting early optic nerve damage.

We are one of the few practices in the U.S. to routinely use VEP testing as part of optic nerve health monitoring. This ensures early intervention if toxicity is detected, protecting both vision and neurological health.

Hope Through Innovation

Though Eales Disease can be visually devastating if left untreated, most patients regain functional vision with early, individualized care. At South Bay Retina, we are committed not just to treating the disease—but to empowering our patients through education, cutting-edge technology, and long-term support.

Don't Wait. Protect Your Vision.

If you or someone you love is experiencing unexplained floaters, blurred vision, or sudden vision loss, prompt evaluation is essential. Watch the Video's here:

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