Iritis

The iris is a circular, pigmented membrane which provides the eye its color and forms the pupil of the eye. Inflammation in the iris is more correctly assorted as anterior uveitis. the ciliary body can also be inflammed and this would then be called iridocyclitis. The iris is a circular muscle near the front of the eye. Besides giving color to the eye, the iris controls the corpus of light which enters the eye through the pupil. Approximately 40% of people with AS will develop iritis and it is usually sudden and recurrent (ie there are repeated attacks often in the other eye) if adhesion is anticipated then a dilating drop is used to relax the ciliary body preventing the iris from adhering to the lens in a closed position. Iritis that is obdurate, recurrent or chronic may require systemic treatment through the use of oral steroids, or other immunomodulating drugs. Just as the shutter controls the amount of light that enters a camera, the iris controls the amount of light which enters the eye. Posterior uveitis emanates due to an unusual inflammation or a reaction against an infection in the eye. Some of these consequences to lack of treatment or under treatment are: epiretinal membrane formation, cystoid Macular edema, cataracts, Glaucoma, detached retina, Vitreous hemorrhage, vascularization of the retina. Uveitis generally is associated with infections, such as herpes, toxoplasmosis, and syphilis; henceforth, the postulated immune reaction directed against foreign molecules or antigens also may injure the uveal tract vessels and cells. Many opthalmologists are not trained in the diagnosis and treament of difficult to regulate uveitis. The iris contains two muscles which control the size of the pupil opening. When too much light is present, the muscles cause the pupil to become smaller to reduce excessive light and glare. In dim light or at night, the muscles make the pupil larger to increase the amount of light entering the eye.

Uveitis is an inflammation (swelling and irritation) of the the uvea. Iritis is inflammation prepotently located in the iris of the eye. Posterior uveitis, also known as choroiditis and chorioretinitis, is uncommon, with the exception of cytomegalovirus (CMV) retinitis in patients with AIDS The eye looks cloudy, the iris (coloured part of the eye) bulges and the pupil (black part of eye) contracts. It has been known cause extreme pain, light sensitivity and sight loss, which is often the result of a disease in another part of the body. Most cases of iritis are recrudescing, in what are small attacks. This causes cloudiness of the fluid behind the cornea of the eye. Some individuals will have genetic predisposition to uveitis which is associated to autoimmune disease processes. The most common of these 'genes' is the HLA B27 Haplotype that can predispose to uveitis alone or also to the Seronegative Spondyloarthropathies and the enteropathic arthropathies. Iritis is typically seen in people with ankylosing spondylitis or reactive arthritis. Uveitis also is present in association with autoimmune disorders, such as systemic lupus erythematosus and rheumatoid arthritis. In such cases, uveitis may be caused by a hypersensitivity reaction comprising immune complex deposition within the uveal tract.

Causes of Iritis

The common causes of Iritis :

Chronic nongranulomatous uveitis is related with juvenile rheumatoid arthritis, chronic iridocyclitis of children, and Fuchs heterochromic iridocyclitis.
Chronic granulomatous uveitis is noticed with sarcoidosis, syphilis, and tuberculosis.
Iritis usually starts as an infection in another part of the body which moves to the eye.
Nontraumatic iritis is frequently associated with certain diseases, such as ankylosing spondylitis , Reiter syndrome, sarcoidosis , inflammatory bowel disease, and psoriasis .
Even when treated early, it often recurs, but usually gradually disappears.
However, iritis may be associated with different forms of autoimmune arthritides, infections, and malignancies.
Blunt trauma to the eye can cause traumatic inflammation of the iris.
Infectious causes may include Lyme disease, tuberculosis, toxoplasmosis, syphilis, and herpes simplex and herpes zoster viruses.

Symptoms of Iritis

Some common symptoms of Iritis :

Blurred vision
Sensitivity to light
Dark, floating spots in the vision
Redness
Throbbing pain
Light Sensitivity
Tearing
Worsened eye pain when exposed to bright light
Reddened eye, especially adjacent to the iris
Eye pain
Watering of the eye
A smaller pupil in the affected eye (occasionally)

Treatment of Iritis

Use prescription medications exactly as prescribed.
Wear dark glasses if light retrograde your eye pain.
The main goals in the ED are to diagnose uveitis correctly and to refer the patient to an ophthalmologist. Although the patient's eye is erythematous and cells are present in the anterior chamber, antibiotics are not indicated.
More severe cases of uveitis may even require treatment with chemotherapeutic agents to suppress the immune system.
The underlying disease may be serious, and additional specialists in infectious disease or autoimmunity may be needed for such diseases as syphilis, tuberculosis, AIDS, sarcoidosis, or Behcet's syndrome.
Treatment may include steroid eyedrops, injections, or pills, as well as eyedrops to dilate the pupil and reduce pain.
For infectious diseases, corticosteroids are often used along with antibiotic therapy.

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