Hektoen International

A Journal of Medical Humanities

Anastasius the “odd-eyes”

Zeynel Karcioglu

Figure 1: Coins of Anastasius I. An information booklet prepared by the Istanbul Archeological Museum (above); the detail of Anastasius I coins (below). (Summer 2015)

Although Anastasius I was one of the most capable Byzantine emperors, he and his reign are little known or discussed in modernity (Figure 1). This may be due to his reign being overshadowed by the more dramatic rule of his close follower, Justinian. Becoming emperor in 491, Anastasius died at the age of eighty-eight after a long reign of twenty-seven years, and is remembered more for his unevenly colored eyes than for his successful military and financial policies and for building the Long Walls of Constantinople.1 He was known as “Odd-Eyes” because one of his eyes was blue and the other green, brown, or black depending on the historical reference. He was also nicknamed “Diokoros,” meaning “with two pupils.”2 As Lascaratos points out, “diokoras” in Byzantine terminology meant “unlike colors of the iridis,” not “two pupils” as it is used now.3,4 In modern terms the emperor had heterochromia iridis (Figure 2), but in his day this condition was considered bizarre, defined at best as a peculiarity.

Flavius Anastasius of Dyrrhachium, as Anastasius was known before ascending the throne, held an unimportant position as one of the noble guards who were the personal escort of Emperor Zeno, his predecessor. When Zeno died in 491 all his children had predeceased him; therefore the supreme power descended onto his widow, Empress Ariadne, who was accused by some of causing her husband’s death (Figure 3).5 Ariadne first made Anastasius her “colleague”, then married him six months later against the wishes of Patriarch Euphemios and also of Zeno, who had wanted his brother Longinos to succeed him. According to some, Anastasius had attracted the attention of the empress, and she had fallen in love with his brilliant, contrasting eyes. Even at the age of sixty, when he became emperor, he was tall and handsome, had attractive facial features and striking eyes. Malalas describes him as follows:

He was very large in stature, short-haired, gracious in manner, round-faced; the hair of his head and beard were turning grey. His right eye was a light blue; the left was dark; nevertheless his eyes were most attractive.6

Only a few depictions of Anastasius’ face have survived to our time. None offer a clue to his heterochromia iridis. Historical texts refer to his “charming” eyes, which had obviously attracted the attention and fondness of the Empress Ariadne.1,5 References are also made to his “penetrating” eyes resting on the crowds in the Hippodrome of Constantinople during the unveiling ceremonies of marble pedestals to honor the charioteer Porphyrios. Anastasius’ eyes were also described as “victorious” while he was rewarding his charioteers with wreaths of victory. A bas-relief sculpture depicting Porphyrios receiving the wreath of victory from the emperor can be seen today in the Istanbul Archaeological Museum in the Salon of Byzantine Art. Although several other bas-reliefs of Anastasius are housed in that museum, they are old and effaced. Based on available depictions, one is not able to detect anything in the carving that indicates the emperor’s heterochromia iridis (Figure 4). Another figure generally identified to be Anastasius is the mounted emperor on the leaf of a diptych known as the Barberini ivory. This carving, now in the Louvre, is one of the finest examples of this form of art and offers intricate details of Anastasius’ face and eyes, but there is no asymmetry of the eyes to indicate heterochromia (Figure 5).7 Neither does the wood engraving of Anastasius by Hartman Schedel depict any difference between his eyes.

Figure 2: (A) Heterochromia in a cat. (B) Heterochromia in a 52-year old man who also has polychromia in the left eye. (C) Bilateral polychromia in a 14-month-old child with Waardenburg syndrome, Type II.

Anastasius is described as having a very “precise vision” in determining the location of the city wall which he drew in 512 across the Thracian peninsula. During the early years of Anastasius’ reign, Slavs and Bulgars invaded Thrace and during one decade defeated the Byzantine army twice. These invasions devastated Thrace and interrupted the capital’s food and water supply. In 503 Anastasius ordered the construction of an outer line of city walls across the Thracian peninsula to prevent the invaders from approaching the suburbs of Constantinople. These walls, known as the Long Walls of Anastasius, stretch for almost seventy kilometers, spanning from the northern coast of the Black Sea to the Sea of Marmara. They proved to be an effective outer defense fortification for the capital.8,9

The other principal monument built under the “discriminating” eyes of Anastasius was the palace of Blachernai, of which the impressive remains of tall windows and arches of vaulted chambers can still be seen on the slope of the Sixth Hill of Istanbul looking down to the Golden Horn. This palace that was built by Anastasius and later expanded by other emperors, and from the time of Alexius I Komnenos became the principal imperial residence.

In view of all the complimentary adjectives describing Anastasius’ eyes in historical texts, one would not think that his heterochromia was due to something that made him less attractive, such as a unilateral uveal inflammation or trauma that would have led to darkening of his left iris. His face has been consistently described as handsome, without scars or asymmetry. Any blemish could have been easily observed and registered by the chroniclers of his time since he was an avid fan of chariot races and spent many of his days at the Hippodrome of Constantinople under the scrutinizing eyes of thousands of his subjects. He also participated in many military campaigns on the Persian frontier under the strong middle eastern sun without anyone observing any symptoms, suggesting that he was born with irises of different color.

On being elected emperor, Anastasius had two aims, to end the hegemony of the Isaurian faction and the influence of the Monophysite heretics. He defeated the Isaurians and removed many of them from Anatolia, but failed in his second objective—so much so that he gradually came to support the Monophysites himself. There was no issue more significant among the subjects of the early Byzantine Empire than religion. Orthodox Christianity was strictly interpreted as “confessing and glorifying the trinity in God the Father, Christ the Son of God, and the Holy Spirit.”10 All subjects of the empire emphatically believed they were Christians, but also were encouraged to subscribe to a very rigid doctrine defining the nature and relationship of the three persons of the Trinity. The slightest deviation from this doctrine was heresy, and it was Anastasius’ misfortune that two rival popes, one in Constantinople and one in Rome, were elected on exactly the same day. The pope in Rome supported a rigid Orthodoxy that did not allow discussion of the single versus the double nature of the Son. The pope in Constantinople, Anastasius’ nominee, favored a compromise between the theory of the single nature and the Orthodox doctrine. His appointment of a pope who favored compromise about the natures of Christ was seen as impious by his enemies, some of whom drew a comparison between the dual appearance of the popes and resulting misfortunes and the dual coloring of his eyes.

Throughout history students of science and medicine have attached considerable significance to eye color. In The Book of Selected Eye Diseases, the nineteenth century surgeon Ammar ibn Ali al-Mawsili divided eye colors into four distinct categories: black, blue, green, and variegated.11 He dogmatically stated that black color arises from seven causes: a decrease in or lack of the visual spirit, clouding of the visual spirit, a small lens, a sunken lens, the amount of proteinaceous liquid, or the turbidity of this liquid. He claimed that the blue color also had seven causes, all the opposite of those of the black color: an increase in the visual spirit or its clarity, the large size of the lens, or the forward displacement of the lens, decreased amount of clear proteinaceous liquid, or the turbidity of the proteinaceous liquid. Al-Mawsili also explained that in some persons the origins for blackness of the iris are mixed with those for blueness, leading to grey, hazel, or differently-colored eyes.

Figure 3: Empress Ariadne.

The phenomenon of differently colored eyes had been recognized since antiquity and was named heteroglaucos by Aristotle. Heterochromia in the modern sense was first described by William Lawrence in A Treatise on the Diseases of the Eye12 and later further elaborated on by Jonathan Hutchinson.13

It is speculative to try to discern the cause of Anastasius’ heterochromia, but certain educated guesses can be entertained. The common causes of hyperchromic heterochromia include prolonged hyphema due to trauma, neoplasia, and anterior uveitis. Eye injury and neoplasia can be easily ruled out in Anastasius’ case. The emperor was very healthy according to all accounts, living to the age of 88 and dying in his sleep.

Although the mechanisms of color change in the iris due to inflammation and atrophy are well known, certain other types, particularly heterochromia related to dispersion glaucoma, inpaired sympathetic denervation, and inherited systemic disorders, are still insufficiently understood. Duke-Elder subdivides heterochromia into five practical, though possibly imperfect categories.14 But the simplest and most practical classification of heterochromia today has two basic categories: hyperchromic and hypochromic. Therefore, in a heterochromic patient, one must first determine whether the hypopigmented or hyperpigmented iris is abnormal. In Anastasius’ case, the darker iris was in the left eye, but there is no evidence that there was disease in either eye that would lead to hyperpigmentation or hypopigmentation. In all likelihood he had simple hereditary heterochromia, and most likely he was a dark-eyed individual with impaired sympathetic innervation and hypopigmentation of his right iris.

When sympathetic denervation (Horner’s syndrome) is the cause of heterochromia, the hypochromia of the iris develops on the side of the denervating lesion, but other stigmata of Horner’s syndrome would be reported present. In another hereditary cause of heterochromia, Waardenburg syndrome, the occurrence of blue eyes in darkly pigmented individuals affirm that the hypochromic eye is the abnormal one and other characteristic featured are also expected to be present (Figure 1).15 Nevus of Ota, another congenital cause of heterochromia, is associated with a bluish discoloration of the periocular skin (blue nevus),16 and is more prevalent in heavily pigmented races. None of these congenital entities seem applicable to Anastasius, whose handsome face was not disfigured by facial abnormalities and whose family members had no such history either.

According to one story, Emperor Anastasius was once struck by lightning, which was interpreted by some as divine wrath for his Monophysite beliefs and by others as a curse because of his unevenly colored eyes. People suspected that his differently-colored eyes were part of what made him unable to be strong and decisive about a major civil problem during his reign—two violently opposed factions of citizens in the city, the Blues and the Greens.

Figure 4: The author in front of Anastasius I column in the Istanbul Archeological Museum.

One of the most striking features of daily life in Constantinople in the early period of the Byzantine Empire, particularly during the reigns of Emperors Anastasius I, Justin I, and Justinian I, was the activity of certain groups associated with the racing factions of the Hippodrome.17 Like many other great Byzantine cities, Constantinople often had to depend on its urban militia, or demes, to defend its walls. According to some other historians, demes were residential areas into which the population of the city was divided, and within these residential areas factions were organized to support rival charioteers competing in the horse races. Since the early days of Rome, four associations of partisans identified with one of the four colors—Blues (Venetoi), Greens (Prasinoi), Whites (Leukoi) and Reds (Srousioi)—associated with those who competed in chariot races. After the establishment of the Eastern Roman Empire, the Reds and Whites did not emerge as independent factions; therefore, two groups only remained, the Greens and the Blues. The members of these factions competed in public games and were also often rowdy partisans at theatrical performances. By the fifth century, both groups were also becoming volatile social forces outside of the Hippodrome. In addition to their roles in the defense and entertainment of the city, the Blues and Greens began to assume a political role, particularly when the emperor began appearing at the Hippodrome. When members of these factions greeted the emperor at the horse races, they had direct access to his ear. The rivalry between the Blues and Greens continually grew more intense and bloodier and periodically exploded into major riots.

Rather than existing as mere sporting associations, the polarization between the major factions reflected the political, social, and religious differences of the population in the city. Although some historians argue that the factions played no detectable part in religious and political disputes, it seems that the Blues and Greens were major social and political forces between the fifth and seventh centuries in Byzantium and terrorized its major cities, particularly Constantinople. The historian Procopius of Caesarea described Byzantine racing factions as follows:18

The members of each faction fight with their opponents not knowing for what reason they risk their lives, but realizing full well that even when they vanquish their opponents in brawls, they will be carted off to prison and that, after they have suffered the most extreme tortures, they will be killed. Therefore, there arises in them an endless and unreasoning hatred against their fellow men, respecting neither marriage nor kinship nor bonds of friendship, even if those who support different colors might be brothers or some other equally close kinship. Even women participate in this abomination, not only accompanying the men but, if the occasion arises, even opposing them, although they do not go to the public spectacles nor are they motivated by any other reason. Thus I, for my part, consider their actions nothing else then a sickness of the soul. And this is how things are among the people of every city.

Figure 5: A leaf of the diptych known as the Barberini Ivory in the Louvre is recognized as a depiction of Emperor Anastasius I.

The Blues and Greens were the standard-bearers of Orthodoxy and Monophysitism, respectively, in the religious controversies of the age. The Blues were Orthodox and therefore, against the emperor; the Greens were for compromise with Monophysitism and stood by the emperor. Anastasius gave his support to the Monophysites, partially in gratitude for the support the Greens gave him politically. Revolts and social unrest caused by the conflict between the two groups continued for years, with Anastasius continually trying to find a compromise. He eventually promised that he would assemble a General Church Consul to resolve the religious conflict, but never kept this promise and left the city and the Byzantine Empire in chaos without ever accomplishing any theological unification. Some have claimed this was due to the “diphysite” nature of his eyes.

The riots continued, one after another. Over time the Greens gained the upper hand through deadly purges. Once they gained control they demanded a face-to-face meeting with the emperor to negotiate a “reform,” but they had no real intention of compromising or negotiating. Administrators worked on many reform prospects and agreed to many of the demands of both factions, but it was a hopeless situation. The conflict was in the hands of extremists, and both factions were out of control. Tolerance or concession on any issue toward one faction was unacceptable to the other side, which always led to direct conflict with the emperor, no matter what the issue was. The Blues were true to their anarchist core, lacking vision and willingness to negotiate. Any gesture of forbearance toward the Blues to ease the tension created waves of malcontent among the Greens. This, in turn, brought the Greens into dispute with the emperor, although he supported them in principle.19

During a riot at the Hippodrome, a frustrated Anastasius offered to abdicate. This caused a tremendous commotion. The Greens urged him to withdraw his abdication; the Blues pelted him with stones. Shortly after this event, the Blues massacred a group of Monophysite priests. With his usual hesitancy, it took a long time for Anastasius to punish the murderers. As a result of the emperor’s tentativeness and procrastination, the Blues became dominant in the city and the Senate. The Blues dominance, however, was short-lived. Vitalian, one of Anastasius’ generals and a Green of Patrician rank, raised an army of 40,000 Thracian Monophysites and led them against the Blues, seizing Constantinople. Anastasius stalled for time while he strengthened the city’s defenses, particularly the imperial fleet. His choice for the command of the Byzantine navy was Marinus, who had decisively defeated the rebel fleet in the naval battle of Chrysopolis.

Anastasius’ financial policies proved to be successful. His earlier experience at the treasury had taught him how to build up a cash reserve. He reformed the tax system, allowing taxes to be collected by imperial officials and thus ensuring the treasury was not defrauded while also protecting the tax-payers. One of Anastasius’ biggest financial reforms was the abolition of the Chrysargyron, an old tax on all receipts that was cruelly enforced on the poor, a reform that was naturally greeted with universal joy by his subjects. Despite spending large sums on public works such as the palace of Blachernai, the cistern of Mokios, and the Long Walls of Constantinople, and on costly military campaigns, his frugal money management led to a substantial surplus of 320 thousand pounds of gold in the treasury at the time of his death.20

Anastasius’ otherwise successful reign was plagued by the interminable riots of the Blues and Greens, who terrorized the city and undermined its stability. Mirroring the split in his eye color, the dichotomy of the people who allied with either the Blues or the Greens also seemed to mimic the contrast between Anastasius’ strengths and weaknesses in decision-making. Perhaps in spirit he despised both factions. He was the only emperor to call himself a member of the Reds, even though the Reds had a very inferior position during his lifetime.21 While modern medicine may be able to make an educated hypothesis about the reason for Anastasius’ heterochromia, modern scholarship will never be able to fully understand his analogous ambivalence on fifth century Byzantine politics and whether one influenced the other.


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DR. ZEYNEL A. KARCIOGLU is a medical/surgical physician, researcher and medical educator specializing in ophthalmic oncology and pathology, presently practicing and teaching at the University of Virginia. He has written numerous scientific papers, book chapters, and books and has given many presentations at regional, national, and international meetings. His tangential interest has been the diseases of the artists and the effects of health problems on their work. To this end, he studied on particular instances of writers’ and artists’ diseases, and has produced a variety of works in general medical humanities.

Highlighted in Frontispiece Volume 7, Issue 3 – Summer 2015 and Volume 13, Issue 4 – Fall 2021

Spring 2015



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