What is Iritis?
Iritis is a form of anterior uveitis. Iritis is an inflammation of the blue or brown portion of the eye called the iris. Iritis can be a onetime event or can become recurrent or chronic.
Signs and Symptoms of Iritis
The symptoms of iritis can appear suddenly and sometimes can progress rapidly over the course of a few days. You will usually not have mucous production or discharge, crusting, mattering, or stickiness.
Usually occurs in one eye
Red or blood shot eye especially near the cornea (clear portion of the eye)
Pain in and around the eye
Photophobia or light sensitivity
The pupil on the side with the iritis may be slightly smaller
Tearing or watering
Floaters many times described as dots or specks floating in the vision
The eye exam will show white blood cells floating in the anterior chamber of the eye. There will be protein in the anterior chamber that appears as a haze of the aqueous humor (fluid in the front portion of the eye). Sometimes due to the inflammation in the eye, the iris will stick or form a scar to the lens in the eye.
What Causes Iritis?
In nearly 75% of initial cases of iritis there will be no known cause. In severe cases of iritis or chronic or recurrent iritis, it is important to run tests to see if there is a cause for the iritis.
Inflammatory and Autoimmune Diseases
Genetic Predispositions Related to Iritis
HLA B27 is the most common gene. These include Ankylosing spondylitis, Reiters Syndrome, irritable bowel disease, psoriatic arthritis, and Crohn’s Disease.
HLA B15 related to Multiple Sclerosis
Other Inflammatory Diseases
Sexually transmitted diseases
Ocular Histoplasmosis syndrome
Cat Scratch disease
Rocky Mountain spotted fever
Lymphoma (Hodgkin’s and non Hodgkin’s)
Diagnosis and Tests
The diagnosis is made by the eye doctor examining the eye and finding inflammatory cells and protein in the anterior chamber of the eye.
The eye doctor will take a detailed history to help determine if there is any underlying systemic disease that could be related to the iritis. A battery of blood tests will be ordered. X-rays of the chest and lower back may be ordered. Also a skin test for tuberculosis may be performed.
Prognosis and Complications
In a rare circumstance, iritis can cause blindness. Iritis needs prompt attention by an ophthalmologist in order to minimize any complications related to iritis. Complications include:
Swelling in the retina
Scarring and atrophy of the iris
Treatment of Iritis
If an underlying systemic disease is associated with the iritis, it will need to be treated along with treating the iris.
Steroid eye drops are the primary form of treatment. If there is concern about the iris scarring to the lens, then dilating eye drops are used as well. In severe cases, oral steroids and steroids injections around the eye may be necessary. It is important that the treatment of the iritis be complete before stopping the medications. Otherwise, it may flare back up. Close patient monitoring is important during the treatment to minimize any complications.