Iritis

What is iritis?

Iritis is the inflammation of your iris and the front part of the eye between the cornea and the iris (anterior chamber). Iritis can lead to serious problems. It can cause severe vision loss and even blindness.

The iris is the colored part of your eye that surrounds your pupil. It controls the size of your pupil. By doing this, it controls how much light enters your eye. The anterior chamber lies in front of your iris. It is a fluid-filled space at the front of your eye. With iritis, this whole area may be inflamed.

Iritis is a type of uveitis. This is inflammation of the uvea. The uvea includes structures called the iris, the ciliary body, and the choroid.  

Iritis may be more common than most people realize. Uveitis is a leading cause of blindness. It can affect children and adults of all ages. It may be slightly more common in young and middle-aged adults.

What causes iritis?

Iritis results from many different causes, such as:

  • Certain other medical problems, such as leukemia and Kawasaki syndrome
  • Eye trauma
  • Infection from bacteria, viruses, parasites, or fungi
  • Inflammatory autoimmune diseases, such as ankylosing spondylitis, lupus, sarcoidosis, and juvenile idiopathic arthritis
  • Injury
  • Reactions to medicines

 In many cases, the cause of iritis is not known.

What are the risks for iritis?

Certain genes may make it more likely that you will get iritis from certain causes.

Having a medical problem that can cause iritis may increase your risk as well. Being female increases your risk for certain kinds of autoimmune diseases linked to iritis.

What are the symptoms of iritis?

One or both eyes may show symptoms, which can range from mild to severe. These symptoms of iritis may include:

  • Decreased vision
  • Eye pain
  • Headache
  • Irregularly shaped pupils
  • Light sensitivity
  • Red eye
  • Vision loss (sometimes a first symptom)

You may have only a single episode of iritis. You may be more likely to battle repeated episodes of iritis if you have an underlying inflammatory disease. Your eye symptoms may tend to be more severe as well.

How is iritis diagnosed?

Your eye doctor diagnoses iritis with the help of a medical history and a physical exam, including a thorough eye exam. Usually, an eye doctor (ophthalmologist) makes the diagnosis. He or she may look into your eye with a slit lamp microscope, which magnifies the surface and the inside of your eye. Your eye doctor may also place eye drops that contain dye onto your eye. This allows a closer look at your cornea, which caps the front of your eye. Your eye doctor will try to determine whether the iritis is the result of an infection.

Your eye doctor may also try to find the cause of your iritis. Additional symptoms can provide clues about the possible cause. You might also need additional testing to determine the exact cause. For example, you might need:

  • Blood tests to check for autoimmune diseases
  • Blood tests to check for infection
  • Chest X-ray or CT scan of the chest to look for sarcoidosis
  • Removal of some fluid from your eye to look for certain rare causes
  • X-ray of your sacroiliac joint

How is iritis treated?

Your treatment will depend on the cause and severity of your iritis. Ideally, therapy should start as soon as possible to help prevent worsening of the iritis and potential damage to eye tissue. Possible treatments include:

  • Antibiotics to treat bacterial infection of your eye
  • Antiviral medicines to treat viral infection of your eye
  • Steroid medicines to treat inflammation
  • Eye drops to dilate your eye, which may prevent some complications
  • In rare instances, other immunosuppressive medicines

Your eye doctor may choose to give some of these medications in the form of eye drops, by mouth, through an IV, or as an injection around your eye.

You might need surgery to treat certain complications from iritis, like cataracts or glaucoma.

What are the complications of iritis?

With prompt treatment, your iritis usually goes away without causing any other problems. However, some people do experience complications from iritis.

Possible complications from iritis include:

  • Abnormal adhesion of the iris to other eye structures (synechiae)
  • Cataracts
  • Calcium deposits on your cornea (band keratopathy)
  • Inflammation of the fluid in the middle of your eye
  • Inflammation of your retina
  • Optic nerve damage
  • Raised pressure inside your eye (glaucoma)
  • Swelling of the back of your eye (macular edema)

If severe, these complications can cause partial or total vision loss. Your eye doctor will try to prevent these complications by treating your iritis promptly. This often requires frequent dosing of medicines to bring the inflammation down.

You might need medicines to treat complications, like glaucoma. In severe cases, you might need surgery to treat one of these complications. For example, you might need surgery to remove a cataract or to repair your cornea.

Your risks of complications may vary based on your age, your other medical conditions, and the cause of your iritis.

Can iritis be prevented?

There is not much you can do to prevent iritis. If you have an autoimmune condition, taking your medicines as prescribed may help prevent iritis. You may reduce your chance for complications if you see your eye doctor at the first sign of symptoms. Make sure to keep any follow-up appointments to make sure your iritis responds to treatment.

If you have certain medical conditions, you may need regular eye exams to check for early signs of iritis. For example, if you have juvenile idiopathic arthritis, you will need regular screenings because vision loss is often the first symptom. Keeping all your screening appointments may help prevent complications from iritis.

When should I call my health care provider?

Call your healthcare provider or eye doctor right away if you have any symptoms of iritis, like eye pain or decreased vision. You may need to see an ophthalmologist that same day. Also call your healthcare provider if your symptoms do not improve.

Key points

Iritis is inflammation of your iris and the front part of the eye between the cornea and the iris (anterior chamber). It sometimes causes serious complications and significant visual loss.

  • Infection, trauma, and autoimmune disease are major causes of iritis.
  • Iritis can cause symptoms like eye pain, light sensitivity, headache, and decreased vision.
  • Your treatment will depend on the cause of your iritis. You may need medicines like antibiotics and steroids.
  • Call your healthcare provider or eye doctor at the first sign of iritis symptoms, or if your symptoms do not improve. This may help reduce your chance of complications.

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