iritis

 

(īrī'tĭs) , inflammation of the iris, the pigmented portion of the eye surrounding the pupil. The condition is sometimes associated with diabetes, with rheumatic diseases such as rheumatoid arthritis, and with infections such as syphilis. Iritis may cause severe pain, a swollen, discolored iris, abnormal sensitivity to light, and blurred vision. If not quickly treated, it may result in impaired vision or blindness. Iritis is treated with antibiotics or other drugs to eliminate infection, atropine to dilate the pupil and prevent scarring, and sometimes steroids to reduce inflammation.

Iritis
Classification & external resources

ICD-10	H20.0
ICD-9	364.0

Iritis is a form of anterior uveitis and refers to the inflammation of the iris of the eye.

Types

There are two main types of iritis: acute and chronic. Acute iritis is a type of iritis that can heal independently within a few weeks. If treatment is provided, acute iritis improves quickly. Chronic iritis can exist for months or years before recovery occurs. Chronic iritis does not respond to treatment as well as acute iritis does. Chronic iritis is also accompanied by a higher risk of serious visual impairment.

Signs and symptoms

• Ocular and periorbital pain
• Photophobia
• Consensual photophobia (pain in affected eye when light is shone in unaffected eye)
• Blurred or cloudy vision
• Reddened eye, especially adjacent to the iris
• White blood cells (leukocytes) (resulting in a grey or near-white haze) and protein (resulting in tiny white dots) in the anterior chamber, often called "cells and flare."
• Synechia or adhesion of iris to lens or cornea

Causes

People with ankylosing spondylitis and other HLA-B27 related disorders are prone to iritis, iridocyclitis, and other forms of uveal tract inflammation. Iritis is also found in those with rheumatoid arthritis, Behcet's disease, Crohn's disease, lupus, Reiter's disease, chronic psoriasis, psoriatic arthritis, sarcoidosis, scleroderma, and ulcerative colitis. Iritis is usually secondary to some other systemic condition, but can be the only apparent somatic symptom.

Complications

Complications of iritis may include the following: Cataract, glaucoma, corneal calcification, posterior uveitis, blindness, band keratopathy, and cystoid macular oedema.

Treatment

• Steroid anti-inflammatory eye drops (such as prednisolone acetate)
• Dilating eye drops (to help prevent synechia and reduce photophobia)
• Pressure-reducing eye drops (such as brimonidine tartrate)
• Oral steroids (such as prednisone)
• Subconjunctival steroid injections
• Steroid-sparing agents such as methotrexate (for prolonged, chronic iritis)

External links

• Care of the Patient with Anterior Uveitis (CPG7) (PDF)
• Iritis Organization
• Assessment of the Red Eye - Iritis
• Medical Info on Iritis

Pathology of the eye (primarily H00-H59, 360-379)
Eyelid, lacrimal system and orbit	Stye - Chalazion - Blepharitis - Entropion - Ectropion - Lagophthalmos - Blepharochalasis - Ptosis - Xanthelasma - Trichiasis - Dacryoadenitis - Epiphora - Exophthalmos - Enophthalmos
Conjunctiva	Conjunctivitis - Pterygium - Pinguecula - Subconjunctival hemorrhage
Sclera and cornea	Scleritis - Keratitis - Corneal ulcer - Snow blindness - Thygeson's superficial punctate keratopathy - Fuchs' dystrophy - Keratoconus - Keratoconjunctivitis sicca - Arc eye - Keratoconjunctivitis - Corneal neovascularization - Kayser-Fleischer ring - Arcus senilis - Band keratopathy
Iris and ciliary body	Iritis - Uveitis - Iridocyclitis - Hyphema - Persistent pupillary membrane
Lens	Cataract - Aphakia
Choroid and retina	Chorioretinitis - Choroideremia - Retinal detachment - Retinoschisis - Retinopathy (Hypertensive retinopathy, Diabetic retinopathy, Retinopathy of prematurity) - Macular degeneration - Retinitis pigmentosa - Retinal haemorrhage - Central serous retinopathy - Macular edema - Epiretinal membrane - Macular pucker
Optic nerve and visual pathways	Optic neuritis - Papilledema - Optic atrophy - Leber's hereditary optic neuropathy
Ocular muscles, binocular movement, accommodation and refraction	Paralytic strabismus: Ophthalmoparesis - Progressive external ophthalmoplegia - Palsy (III, IV, VI) - Kearns-Sayre syndrome Other strabismus: Esotropia/Exotropia - Hypertropia - Heterophoria (Esophoria, Exophoria) - Brown's syndrome - Duane syndrome Other binocular: Conjugate gaze palsy - Convergence insufficiency - Internuclear ophthalmoplegia - One and a half syndrome Refractive error: Hyperopia/Myopia - Astigmatism - Anisometropia/Aniseikonia - Presbyopia
Visual disturbances and blindness	Amblyopia - Leber's congenital amaurosis - Subjective (Asthenopia, Hemeralopia, Photophobia, Scintillating scotoma) - Diplopia - Scotoma - Anopsia (Binasal hemianopsia, Bitemporal hemianopsia, Homonymous hemianopsia, Quadrantanopia) - Color blindness (Achromatopsia) - Nyctalopia - Blindness/Low vision
Pupil	Anisocoria - Argyll Robertson pupil - Marcus Gunn pupil/Marcus Gunn phenomenon - Adie syndrome
Infectious diseases	Trachoma - Onchocerciasis
Other	Nystagmus - Miosis - Mydriasis - Glaucoma - Floater - Leber's hereditary optic neuropathy - Red eye - Keratomycosis - Xerophthalmia - Aniridia

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