Jesse James’ strongest features were his soul-piercing crystal blue eyes.
Phillip Steele, in his 1995 book Many Faces of Jesse James, reported that “[James] family records tell of Jesse James’ strongest features being his soul-piercing crystal blue eyes.
“Sensitive to light, Jesse was known to blink often and experienced a granulated eyelid condition that occasionally caused swelling….”
Several others have recorded the outlaw’s eye problems. In 1925’s The Rise and Fall of Jesse James, Robertus Love vividly described an episode when northern militiamen whipped 15-year-old Jesse just after they had attempted to hang his stepfather, Southern sympathizer Dr. Reuben Samuel. Rather than hang Jesse, they used a rope to drive him from the cornfield where he had been working. Love indicated: “When Jesse reached the house, running hard, his eyes were blinking more rapidly than ever. As a child he had suffered granulated eyelids. Throughout the rest of his life, he had the involuntary habit of blinking. They were large eyes, of a light blue shade.”
In 1993’s Age of the Gunfighter, Joseph G. Rosa states of Jesse: “Some recalled that his eyes were constantly on the move and he blinked all of the time. Others credited this to a complaint known as granulated eyelids, but it was far more likely that he suffered from trachoma, which was common at the time, that could cause pain and discomfort, yet it did not necessarily endanger the sight, but it did require treatment.”
What medical malady could have caused Jesse’s problems of “granulated eyelids,” occasional eyelid swelling and frequent blinking reported by these different sources?
Following my general review of these descriptions of Jesse’s eye problems, I medically reason that Jesse’s condition was chronic. It began in childhood or adolescence, caused frequent blinking, light sensitivity (“photophobia”) and occasional bouts of eyelid swelling; yet it did not cause any reported impairment of vision.
First, consider trachoma, a highly communicable, progressively destructive, bacteria–like organism that is still the world’s leading cause of blindness.
Dr. Paul Roemer noted in his 1912 Textbook of Ophthalmology, “…we shall be obliged to define trachoma …as the follicular disease of the conjunctiva [eye membrane] that results in cicatrization [scar formation].”
The clinical course of such an infection, beginning in a youngster and left effectively untreated for decades, would have resulted in more severe complications and clinically obvious signs in Jesse than appeared to have occurred. I cannot find any evidence that he suffered from progressive conjunctival scarring or visual impairment during his lifetime.
Next, consider “granulated eyelids,” known today as eyelid inflammation or “blepharitis.”
Dr. Roemer also discusses inflammatory diseases of the eyelids, specifically, the sebaceous (oil-producing) meibomian glands, responsible for lubricating the eyelid margins. Chronic inflammation of these glands can lead to scarring in the gland ducts, a reduction in eyelid lubrication, dry eyes, photophobia and frequent blinking.
When the glandular ducts are occasionally blocked, swelling of the lid may occur with the formation of a chalazion or eyelid cyst. The causes of inflammation can range from frequent dust exposure, repeatedly rubbing the eyes and recurrent viral or bacterial infections, including, in those days, TB, syphilis and even trachoma.
Without better evidence of untreated trachoma’s destructive history of conjunctival scarring, my final diagnosis is that Jesse probably suffered from chronic, intermittent meibomitis or inflammation of the meibomian glands, which persisted following severe childhood infection.
All of Jesse’s reported symptoms can be explained by this diagnosis. His constantly dragging, poorly lubricated and chronically inflamed eyelids across the surfaces of his eyes, including his cornea, probably resulted in corneal irritation, photophobia and frequent blinking. Occasional eyelid swelling occurred when an eyelid cyst formed.
Those dramatic reports of his large, piercing, light blue eyes, without any mentioning of obvious reddening or scarring of the conjunctiva (medical “pertinent negatives”), further support the improbability of trachoma infection or even chronic allergies. Jesse’s problems persisted in the pre-antibiotic era, because most remedies were largely ineffective in chronic cases.
Whatever its actual cause, Jesse’s annoying, albeit non-life threatening, disorder was inconveniently “cured” by “that dirty little coward…” Bob Ford on April 3, 1882.