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Installation view from Manchester International Festival 2023 exhibition Yayoi Kusama:
You, Me and the Balloons at Aviva Studios. Images © David Levene. 


On an uncharacteristically salubrious 5 July 2023, the date of the 75th Anniversary of the UK’s NHS, a regional symposium took place in Manchester, organised and chaired by myself and fellow Ophthalmic Physician Dr Amira Stylianides (Manchester Royal Eye Hospital).

We invited attendees from our region in the North-West of England and North Wales to a session covering protean manifestations of non-infectious ocular inflammation in the eye. This gathering was a second-leg, after we hosted our inaugural session on infectious uveitis at the beautiful RCP Spine in Liverpool.

For the return fixture at The University of Manchester Core Technology Facility, the speakers were again all uveitis specialists, who shared a link to the North-West of England (either through training, fellowships, consultant posts or indeed a combination). We covered realms of the unknown and hermetical in ocular inflammation, which still incorporates so much mystery within a spectrum of heterogeneous and complex diseases.

When the training day concluded, I visited the new Yayoi Kusama exhibition You, Me and the Balloons at the recently launched Aviva Studios, part of Factory International and the Manchester International Festival.


Yayoi Kusama. Courtesy of Ota Fine Arts, Victoria Miro,
and David Zwirner © Yayoi Kusama.


Yayoi Kusama is now 94-years-old. The nonagenarian suffers from psychedelic schizophrenia, experiences visual hallucinations and has lived at the Seiwa Hospital for the Mentally Ill since 1977. Creating art, she says, has helped her cope with “traumatic mental states”.

This exhibition is a fitting follow-on from last year’s Infinity Mirror Rooms & Chandelier of Grief at the Tate Modern, allowing fans of her contemporary art to keep their polka dots and pumpkins quota intact.

Whilst looking at her creations, these vibrant colours and infinite patterns, I reflected on the kaleidoscopic nature of ocular inflammation (and the day as a whole). Her fantastical creations juxtaposed neatly with the intricate complexities of uveitis, where we often need to think outside traditional medical frameworks. Do the repetitive patterns, particularly her iconic polka dots, reflect the recurring nature of uveitis flares, and the chronicity which we can see with uveitis? Our University of Liverpool Faculty of Health & Life Sciences medical student, Ms Erin White, neatly summarised her project exploring the use of long-acting steroid treatments in non-infectious uveitis.


Life of the Pumpkin Recites, All About the Biggest Love for the People, 2019
Installation view from Manchester International Festival 2023 exhibition
Yayoi Kusama: You, Me and the Balloons at Aviva Studios. Images © David Levene. 


The pumpkin — metaphor for uveitis

Amongst the cucurbit family of herbaceous fruits, is there any more apt a metaphor than a pumpkin? The full and plump pumpkin contains multiple layers — the outer skin, flesh and the seeds can reflect the iris, ciliary body and choroid and the inflamed state of uveitis can be symbolised by this fruit being ceremonially carved for Halloween.

In our session, there was an emphasis on “thinking outside-the-box” for challenging uveitis cases…


For me, the world is genuinely full of surprises. It is not that I want to inspire a childlike awe or wonder, but to inspire through my genuine perception of the world.
– Yayoi Kusama


Sometimes, finding a cause for inflammation needs a little deeper delving. In ‘Tissue is the Issue’, our speaker Dr Greg Heath, Consultant Medical and Neuro-Ophthalmologist at York and Scarborough Teaching Hospitals NHS Foundation Trust, gave us three fascinating cases all of which were indeed full of surprises where the diagnosis may have been clear, but was it? Just as in themes of individuality and identity in Kusama’s art, each case can be an enigma.

Pathways of inflammation

In You, Me and the Balloons, these coruscating yellow tentacles are designed to suggest ‘roots, tentacles or neural pathways’. For our meeting, Dr Paul Steptoe explained the pathways which may be leading to the inflammatory chorioretinopathy, acute posterior multifocal placoid pigment epitheliopathy, and our approaches to this condition, highlighting a neurotrophic infection model.


Yayoi Kusama and Dots Obsession, 1996-2011 Installation view, The Watari Museum of
Contemporary Art, Tokyo. © Yayoi Kusama. Courtesy of Ota Fine Arts, Victoria Miro and David Zwirner. 


Yayoi Kusama, The Hope of the Polka Dots Buried in Infinity will Eternally
Cover the Universe, 2019. Installation view, Fosun Foundation,
Shanghai. Courtesy of Ota Fine Arts and Victoria Miro. © Yayoi Kusama.



Dots Obsession, 2013 Installation view from Manchester International Festival 2023
exhibition Yayoi Kusama: You, Me and the Balloons at Aviva Studios. Images © David Levene.


Accordingly, the personalised nature of uveitis was emphasised — from patient experience, disease presentation, treatment response and impact on daily life. Just as Kusama celebrates individuality through her art, acknowledging the diversity of uveitis manifestations is crucial in tailoring treatment plans and providing patient centricity.

The larger picture

Kusama’s immersive installations often create a sense of infinite space through the use of mirrors and repeated motifs. This might symbolise the vastness and complexity of uveitis, which can affect multiple structures within the eye and have systemic implications.


The author pictured at the exhibition.


Kusama’s dots and patterns connect to form a larger composition, in parallel the talk from Dr Eleftherios Agorogiannis intricately highlighted how the network of retinal blood vessels is interconnected and vital for visual function — covering how retinal vasculitis affects the delicate network of blood vessels in the eye, where inflammation disrupts the normal flow and pattern of blood circulation.


Our earth is only one polka dot among a million stars in the cosmos and polka dots are a way to infinity. When we obliterate nature and our bodies with polka dots, we become part of the unity of environment.
– Yayoi Kusama


Kusama’s vivid colour palette evokes strong emotions and stimulates sensory experiences. Uveitis, too, can prompt a range of emotions in patients, including fear, frustration and uncertainty due to its potential impact on vision and quality of life. The vibrancy in Kusama’s art serves as a visual representation of the emotional landscape experienced by this disease. I explored this in my session ‘Vision and Vigilance’, in which we investigated judgement calls which can impact the lives of patients, not just their eyesight, looking to the present and the future of life-saving cancer treatments which can affect the eye.

I augmented my talk with a few AI-influenced artworks, harnessing the power of machine learning Midjourney to generate art which represents the beauty of the human eye, and the symbiosis between art and science. Considering vision and eyecare through a multi-dimensional lens allows us to approach patient care with increased creativity and empathy.

I thank you for humouring me with this tenuous analogy, which I hope emphasises the art within medical practice, especially in conditions which are not yet fully understood!


The next Inflammation session will return to Liverpool in January 2024.


Yayoi Kusama: You, Me and the Balloons is presented as part of Manchester International Festival 2023.
30 June – 28 August 2023, Aviva Studios, Manchester, UK.



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