Iritis: Causes, Symptoms, Diagnosis, Treatment, Prognosis, Complications and Prevention

Iris tissue is present in conjunction with other structures.

It is a pigmented circular portion that provides the opening for light to enter and that is in the front of the eye. In the center is the dark pupil.

It is one of the three main parts of the uvea , which is the middle layer of the eye and is responsible for giving a particular color to the eyes.

The pupil in the center of the iris controls the amount of light that enters the eye.

The main function of the iris is to control the amount of light that enters the eye by adjusting the size of the pupil.

It makes the pupil aperture smaller in bright light and larger in low light.

Under certain conditions, the iris becomes inflamed and this inflammation is called Iritis.

Traumatic iritis is a condition that occurs due to trauma or injury that occurs to the iris. Iritis is a subtype of uveitis.

Iritis does not have a clearly identified cause, although some are sometimes mentioned such as infectious diseases and, more rarely, venereal diseases, as well as infections caused by protozoa and yeasts.

Iritis is characterized by swelling and irritation of the eye and usually affects only one eye.

This condition is commonly caused by autoimmune diseases and occurs mainly in healthy people (young and middle-aged people).

Inflammation of the iris is rarely isolated. She is 90% associated with iridocyclitis.

Iridocyclitis is often associated in turn with inflammation of the choroid or choroiditis.

This is because the iris, ciliary body, and choroid form the structure called the uvea.

The inflammation of the 3 elements: lairitis, cyclitis and choroiditis correspond to the inflammation of the uvea. And it is known as uveitis.

Some people have iritis, it is a type of uveitis in which the diaphragm is inflamed.

The patient must deal with the irritation as quickly as possible to prevent complications.

The prevalence of iritis is approximately 8 to 15 per 100,000. There are no racial or significant differences. Also, iritis can affect both men and women.

Iritis occurs in all ages, but especially in people between the ages of 40 and 60.

Causes of iritis

In many cases, iritis occurs spontaneously and the cause is unknown. Associated causes include trauma and infection.

The trauma can be surgical, for example cataract surgery, or an accident that causes a blunt or penetrating injury.

Trauma such as a blunt object to the eyes, burns, among other injuries sometimes cause acute iritis.

An especially strong iritis is produced by an organic ocular foreign body retained in the iris. The corneal infections cause iritis.

Numerous systemic conditions are also associated with iritis.

Iritis is seen in some patients with autoimmune disease who have conditions associated with decreased resistance to infection, in which impaired immunity causes inflammation of the iris.

Systemic steroid use iritis, AIDS, ankylosing spondylitis , Reiter’s syndrome, Behçet’s disease, sarcoidosis, inflammatory bowel disease, and rheumatoid psoriasis often develop .

Infectious causes that lead to acute or chronic iritis include Lyme disease, infections such as tuberculosis, toxoplasmosis, syphilis and herpes simplex, the herpes zoster virus, and other sexually transmitted infections.

The JRA sometimes leads to chronic iritis.

Juvenile rheumatoid arthritis is the most common association with iritis in childhood, although granulomatous iritis is often due to sarcoidosis.

In general, iritis associated with active systemic disease responds poorly to standard treatment and can recur frequently.

Some medications can also cause iritis.

Iritis is usually caused by an infection secondary to:

  • Sinusitis.
  • A urinary infection
  • A dental abscess.
  • Brucellosis (infectious disease of vertebrate animals, transmissible to humans).
  • A shingles.
  • A parasitic disease.

The symptoms

Iritis usually develops rapidly, and usually only one eye is affected, but it is also bilateral.

The patient has one or more of the following symptoms: floating spots in the field of vision, sensitivity to light, headache, small pupil, pain in the eyes or forehead, red eyes, and blurred vision.

In chronic iritis, symptoms persist for more than six weeks.

Iritis, is associated more with the deterioration of the ciliary body, then that constitutes iridocyclitis, which is relatively common inflammation that can be acute or chronic.

Their tendency to relapse generally affects both eyes.

Iritis usually clears up within a few days, but it can last for months or become chronic and recurrent.

It is very important that it is identified and treated without delay.

Diagnosis of iritis

A comprehensive eye exam with the ophthalmologist is required . This test involves:

External examination

With the help of a flashlight the pupils are examined and redness is observed in one or both eyes, and look for any signs of fluid discharge.

Slit Lamp Exam

This test is performed to closely examine the cornea of ​​the eye, the iris, the lens and the space between the iris and the cornea, this test helps the doctor to examine the eye in small and detailed sections and makes it easier to detect any abnormalities.

In the diagnosis of iritis carried out in ophthalmoscopy on the basis of a slit lamp. The ophthalmologist sees cells and a glow in the fluid produced by the eye.

Dilated eye exam or retinal exam

This test is done to examine the back of the eyes (the retina). For this, drops are placed in the eyes to widen or dilate the pupils.

Visual acuity

The doctor assesses visual acuity using the eye chart and other tests.

If a disease or condition is suspected to be causing the iritis, the underlying cause should be determined.

If this is the case, other tests should be done which may include doing some blood tests or imaging tests to identify or rule out other diseases like infections and an autoimmune disorder.

Treatment

Treatment is done as quickly as possible to avoid serious complications.

The patient is regularly prescribed medications to control pain, inflammation, protect vision, and discomfort from irritation.

Dark glasses should also be worn, as pain worsens when light shines on the eyes.

The ophthalmologist prescribes steroid eye drops unless a virus or bacteria causes iritis. In this case, antibiotics should be prescribed.

The duration of treatment depends on the severity of the disease.

If the symptoms of iritis do not go away, or seem to be getting worse, the ophthalmologist may prescribe oral steroid medications or some other anti-inflammatory agent, depending on the general condition of the patient.

When an underlying cause is suspected, it must, of course, be treated simultaneously.

Treatment is generally effective, but constant monitoring is necessary because recurrence is common. The patient should regularly visit the ophthalmologist.

Prognosis of iritis

Untreated iritis can cause glaucoma, cataracts, an irregular pupil, calcium deposits in the cornea, and macular edema, resulting in partial or complete vision loss.

When the cause of iritis is traumatic, it usually disappears in less than two weeks. But nontraumatic iritis sometimes takes weeks and even months.

Infectious iritis goes away after treatments are started.

In some patients with systemic diseases such as sarcoidosis and ankylosing spondylitis, the iritis is chronic or recurrent.

Most cases of iritis are usually treated within a few days or weeks with proper treatment.

However, iritis caused by systemic diseases can reappear after a few days or months.

Complications

Promptly and even recurrent iritis has a good visual prognosis.

However, if inflammation is not controlled, cataract, glaucoma, and degenerative corneal change (band keratopathy) occur as a complication of prolonged intraocular inflammation.

Long-term use of topical steroids alone can cause cataracts and glaucoma, as well as making the cornea more vulnerable to infections, such as herpes simplex keratitis.

When complications are severe, some form of blindness may develop in addition to glaucoma.

Continuous monitoring of the eye is necessary, since iritis has a tendency to recur.

Therefore, it is not prudent to treat iritis with topical steroids without initial slit lamp examination and subsequent monitoring of response to treatment and possible comorbidities.

Idiosyncratic elevation of intraocular pressure can occur with topical steroids and may need long-term glaucoma care, even if the drops are stopped.

If iritis is not treated in time, it can lead to several complications, such as:

  • Loss of vision
  • Retinal detachment.
  • Waterfalls.
  • Inflammation of the retina.
  • Glaucoma.

When cases of iritis are very severe, surgery may be necessary, especially when cataracts occur due to inflammation or the accumulation of calcium in the cornea or due to the effect of corticosteroids.

In these more serious cases, the doctor may recommend surgery.

Prevention of iritis

Although iritis cannot be prevented, there are a few simple things to keep in mind to maintain eye health.

These include:

  • Eat a healthy nutrient-dense diet (include more green and red foods).
  • Drink lots of water.
  • Yoga is good for your overall health, including your eyes.
  • Eye checkups or exams should be done at least once a year.