Definition of Iritis
Iritis (i-RIE-tis) is inflammation that affects your eye’s iris, the colored ring surrounding your pupil. The iris is a part of the middle layer of the eye (uvea), so iritis is a type of uveitis, sometimes called anterior uveitis.
The cause of iritis is often unknown. Sometimes iritis results from an underlying systemic condition or genetic factor.
Iritis is a serious condition that, if left untreated, could lead to glaucoma or vision loss. If you have symptoms of iritis, see your doctor as soon as possible.
Symptoms of Iritis
Signs and symptoms of iritis may include:
- Eye redness
- Discomfort or achiness in the affected eye
- Sensitivity to light (photophobia)
- Blurred vision
- Floating specks or spots in your vision
Iritis that develops suddenly, over hours or days, is known as as acute iritis. Symptoms that develop gradually or last longer than six weeks indicate chronic iritis.
When to see a doctor
See an eye specialist as soon as possible if you have symptoms of iritis. Prompt treatment helps prevent serious complications. If you’re experiencing eye pain and vision problems with other signs and symptoms, you may need urgent medical care.
Often, the cause of iritis can’t be determined. In some cases, however, iritis can be linked to eye trauma, genetic factors or certain diseases. Known causes of iritis include:
- Injury to the eye. Blunt force trauma, a penetrating injury, or a burn from a chemical or fire can cause acute iritis.
- Infections. Shingles (herpes zoster) on your face can cause iritis. Other infectious diseases, such as toxoplasmosis, histoplasmosis, tuberculosis and syphilis, may be linked to other types of uveitis.
- Genetic predisposition. People who develop certain autoimmune diseases because of a gene alteration that affects their immune systems might also develop acute iritis. Diseases include ankylosing spondylitis, Reiter’s syndrome, inflammatory bowel disease and psoriatic arthritis.
- Behcet’s disease. An uncommon cause of acute iritis in Western countries, this condition is also characterized by joint problems, mouth sores and genital sores.
- Juvenile rheumatoid arthritis. Chronic iritis can develop in children with juvenile rheumatoid arthritis.
- Sarcoidosis. This autoimmune disease involves the growth of collections of inflammatory cells (granulomas) in areas of your body, including your eyes.
- Certain medications. Some drugs, such as the antibiotic rifabutin (Mycobutin) and the antiviral medication cidofovir (Vistide) that are used to treat HIV infections, might cause iritis. Stopping these medications usually stops the iritis symptoms.
Your risk of developing iritis increases if you:
- Have a specific genetic alteration. People with HLA-B27, a specific change in a gene that’s essential for healthy immune system function, are more likely to develop iritis.
- Develop a sexually transmitted infection. Certain infections, such as syphilis or HIV/AIDs, are linked with a significant risk of iritis.
- Live in certain geographic locations where infectious causes are more prevalent, for instance, in the U.S. in the Ohio or Mississippi river valleys where histoplasmosis — a fungal infection — occurs more frequently.
- Have a compromised immune system or autoimmune disorder.
Complications of Iritis
If not treated properly, iritis could lead to complications, including:
- Cataracts. Development of a clouding of the lens of your eye (cataract) is a possible complication, especially if you’ve experienced a long period of inflammation.
- An irregular pupil. Scar tissue can cause the iris to stick to the underlying lens or the peripheral cornea, making the pupil irregular in shape and the iris sluggish in its reaction to light.
- Glaucoma. Recurrent iritis can result in glaucoma, a serious eye condition characterized by increased pressure inside the eye (intraocular) and possible vision loss.
- Calcium deposits on the cornea (band keratopathy). This condition results in degeneration of your cornea and could decrease your vision.
- Swelling within the retina (cystoid macular edema). Swelling and fluid-filled cysts that develop in the retina at the back of the eye (macular retina) can blur or decrease your central vision.
Preparing for your appointment
Make an appointment with a doctor who specializes in eye care — an optometrist or an ophthalmologist — who can evaluate iritis and perform a complete eye exam.
What you can do
Make the best use of time with your doctor by preparing for your visit.
- Write down your symptoms, including any that may seem unrelated to your vision problem.
- Make a list of all medications, vitamins or supplements you’re taking.
- Ask a family member or friend to accompany you. Having your pupils dilated for the eye exam will affect your vision for a time afterward. You may need someone to drive or accompany you after your appointment.
Questions to ask your eye doctor
- Can iritis permanently affect my vision?
- Do I need to come back for follow-up exams? When?
- What should I do if my symptoms don’t go away or seem to worsen?
Questions your eye doctor may ask
- When did you first notice symptoms?
- Are symptoms present in one or both eyes?
- Do you feel pain in your eye after touching your eyelid?
- Do you have headaches?
- Does bright light worsen your eye pain?
- Is your vision blurred?
- Do you have trouble with near or distance vision?
- Have you recently had an injury or other trauma to your eye?
- Have you recently been ill?
- Do you have symptoms of arthritis, such as joint pain?
- Do you have sores in your mouth or on your genitals?
- Have you been diagnosed with iritis before?
- Have you been diagnosed with other eye conditions?
Tests and diagnosis
Before diagnosing iritis, your eye doctor will conduct a complete eye exam, including:
- External examination. During an external exam, your doctor may use a penlight to look at your pupils, observe the pattern of redness in your eye or eyes, and check for signs of discharge.
- Visual acuity. Your doctor will note your visual acuity using an eye chart and other standard tests.
- Slit-lamp examination. Using a special microscope with a light on it, your eye doctor views the inside of your eye looking for signs of iritis. Dilating your pupil with eyedrops enables your doctor to see the inside of your eye better.
- Glaucoma testing. This measures the pressure in your eyes (intraocular pressure). Elevated pressure indicates that you may have glaucoma.
If your eye doctor suspects that a disease or condition is causing your iritis, he or she may work closely with your primary care provider to pinpoint the underlying cause. In that case, further testing may include blood tests or X-rays to identify or rule out specific causes.
Treatments and drugs
Iritis treatment targets preserving vision and relieving pain and inflammation. If your iritis is associated with an underlying condition, treating that condition also is necessary.
Most often, treatment for iritis involves:
- Steroid eyedrops. Glucocorticoid medications, given as eyedrops, reduce inflammation.
- Dilating eyedrops. Eyedrops used to dilate your pupil can reduce pain associated with iritis. Dilating eyedrops also protect you from developing complications that interfere with your pupil’s function.
If your symptoms don’t clear up, or seem to get worse, your eye doctor might prescribe oral medications that include steroids or other anti-inflammatory agents. Your doctor will consider your overall condition before prescribing oral medications to treat your iritis.