contacts-logo Iritis / Anterior Uveitis

What is Iritis?

Iritis is inflammation located in the iris of the eye.  The iris is the colored portion of the front of the eye surrounding the pupil.  The iris controls the amount of light entering the eye by making the pupil smaller in bright light and larger in dim light.  Inflammation in the iris is more correctly classified as anterior uveitis, whereas inflammation behind the iris is classified as posterior uveitits.  Anterior uveitis is the more common of the two.  The inflammation may be associated with autoimmune diseases, but most cases occur in healthy people and have no known cause.  It is most prevalent in young and middle-aged people. 


Causes of Iritis

Iritis can be caused by autoimmune disorders such as rheumatoid arthritis or ankylosing spondylitis, infection, or exposure to toxins.  Iritis can also be induced by blunt trauma to the eye, referred to as traumatic iritis.  However, in many cases the cause is unknown.

Anterior uveitis/iritis can be associated with any of the following: 

  • AIDS

  • Ankylosing spondylitis

  • Behcet syndrome

  • CMV retinitis

  • Herpes zoster infection

  • Histoplasmosis

  • Injury

  • Kawasaki disease

  • Psoriasis

  • Reactive arthritis

  • Rheumatoid arthritis

  • Sarcoidosis

  • Syphilis

  • Toxoplasmosis

  • Tuberculosis

  • Ulcerative colitis 

Again, in a significant number of cases, no cause for the iritis is found.  Systemic disease must be ruled out with recurrent episodes or in severe or atypical cases of ititis.   

Signs and Symptoms of Iritis

Iritis may affect only one or both eyes, although it usually occurs in only one eye. Symptoms typically develop rapidly, although they can have a slow, insidious onset, especially with recurrences.  Signs and symptoms may include any or all of the following: 

  • Blurred vision

  • Eye pain (sometimes significant)iritis anterior uveitis resized 600

  • Increased eye pain when exposed to bright light

  • Redness of the eye, especially surrounding the iris

  • Dark, floating spots in vision

  • A smaller than normal pupil (miotic pupil)

  • Low eye pressure

  • Tearing

  • Headache

When inflammation is present in the iris, white blood cells are shed into the anterior chamber of the eye where they can be observed by an eye doctor by biomicroscopic slit lamp examination with high magnification.  Pupils may also appear small or irregularly shaped upon examination.  Intraocular eye pressure can be reduced because the iris is an extension of the part of the eye that produces the intraocular fluid; hence, when inflamed, production of that fluid can be affected.

There is no mucus discharge in iritis as in many cases of conjunctivitis (pink eye).

Treatment for Iritis

It is very important to differentiate iritis from other similar red eye appearances.  Once the diagnosis is confirmed, iritis is treated very aggressively with the most potent corticosteroid eye drops.   Our eye doctors will prescribe the appropriate treatment after a thorough evaluation of the anterior and posterior portion of the eye.  In order to have a significant impact on the inflammation, the corticosteroid eye drops must be a very potent variety.  The steroid drops are often prescribed to be used every hour or every two hours.  Steroids must be tapered gradually or there is a risk that the Master eye doctor diagnosing iritis eye diseaseinflammation could come back worse than the initial onset.  In addition to the potent corticosteroid eye drops the pupils are dilated for days or possibly weeks depending on the severity of the condition. Long acting dilating drops are used to sustain dilation for extended periods of time to prevent synechiae (adherence of the iris to the crystalline lens) and to reduce the discomfort of the patient by reducing ciliary spasm.  Regular follow-up appointments with the prescribing eye doctor are important in managing anterior uveitis (iritis) and to be assured that high eye pressure does not develop as a side effect of the corticosteroid treatment.

Because iritis may be associated with a number of conditions in the body that are inflammatory or infectious in nature additional tests may be ordered by the eye doctor.  There is more suspicion of a systemic cause if iritis becomes recurrent, severe or if both eyes have been affected at the same time.  In order to determine an underlying body disease, laboratory tests and/or referral to an internal medicine specialist will be performed.

If iritis becomes chronic and is left untreated, it can result in glaucoma and/or cataracts, which can lead to significant decreased vision. To make sure this eye condition is not missed it’s important to go to an eye doctor if you have these symptoms or if the symptoms are not improving with treatment or if they recur after discontinuing treatment.  In general, emergency doctor physicians do not have the equipment to properly diagnose iritis.

Prognosis of Iritis

The course and prognosis of iritis (anterior uveitis) depends on the cause and severity of the inflammation.  Iritis is not a quick fix like a conjunctivitis (pink eye) condition.  Iritis requires longer periods of medical treatment and monitoring.  Severe iritis takes longer to treat and is more likely to cause complications than a mild form of iritis.  However, anterior uveitis is usually easier to treat and heals more rapidly with fewer consequences than posterior uveitis.