Iritis

What is iritis?

Iritis is an inflammation of the colored part of your eye (iris). It also affects 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 goes around the black part of your eye (pupil). It controls the size of your pupil. By doing this, it controls how much light enters your eye. The anterior chamber is in front of your iris. It is a fluid-filled space in 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 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 can be caused by many different things, such as:

• Other health problems, such as leukemia and Kawasaki syndrome

• Eye injury

• 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 is not known.

Who is at risk for iritis?

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

Having a health problem that can cause iritis may raise your risk as well. People assigned female at birth are at greater risk for certain kinds of autoimmune diseases linked to iritis.

What are the symptoms of iritis?

You may have symptoms in one or both eyes. They can range from mild to severe. Symptoms of iritis may include:

• Reduced vision

• Eye pain

• Headache

• Abnormally shaped pupils

• Light sensitivity

• Red eye

• Tearing

• Vision loss (sometimes the first symptom)

You may have only 1 case of iritis. You may be more likely to have repeated cases if you have an underlying inflammatory disease. Your eye symptoms may tend to be more severe as well.

How is iritis diagnosed?

Your eye care provider makes the diagnosis with a health history and a physical exam. This includes a full eye exam. Your provider may look into your eye with a slit lamp microscope. This magnifies the surface and the inside of your eye. They may also place eye drops that contain dye onto your eye. This gives them a closer look at the clear layer that covers the front of your eye (the cornea). Your provider will try to find out if the iritis is caused by an infection.

Other symptoms can also give clues about the possible cause. You may need more tests to find the exact cause. For example, you may 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 or tuberculosis

• 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, treatment should start as soon as possible. This can help prevent the condition from getting worse. It can also help prevent possible damage to eye tissue. Possible treatments include:

• Antibiotics to treat bacterial eye infection

• Antiviral medicines to treat viral eye infection

• Steroid medicines to treat inflammation

• Eye drops to widen (dilate) your pupils, which may prevent some complications and can reduce pain

• In rare cases, other medicines to suppress your immune system (immunosuppressives)

Your eye care provider may choose to give some of these medicines in the form of eye drops, by mouth, or through an IV (intravenous) line. Or they may be given as a shot (injection) around or into your eye.

You might need surgery to treat some complications from iritis. These include cataracts and glaucoma.

What are possible complications of iritis?

With quick treatment, iritis often goes away without causing any other problems. But some people do have 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, which lines the back of your eye

• Optic nerve damage in severe cases, causing blindness

• High pressure inside your eye (glaucoma)

• Swelling of the central part of the retina (macular edema)

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

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

Your risk for complications may vary based on your age, your other health 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 problems if you see your eye care provider at the first sign of symptoms. Keep any follow-up appointments to make sure your iritis responds to treatment.

If you have certain health 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. That's because vision loss is often the first symptom. Going to all your screening visits may help prevent problems from iritis.

When should I call my eye care provider?

Call your eye care provider right away if you have any symptoms. This includes eye pain or reduced vision. You may need to see your eye care provider that same day. Also call your eye care provider if your symptoms don't get better.

Key points about iritis

• Iritis is the inflammation of the colored part of your eye (iris).

• It can cause symptoms such as eye pain, light sensitivity, headache, and decreased vision.

• It can lead to serious problems such as severe vision loss and even blindness.

• Infection, injury, and autoimmune disease are major causes.

• You may need medicines such as antibiotics and steroids.

• Call your eye care provider at the first sign of symptoms, or if symptoms don't get better.

Next steps

Tips to help you get the most from a visit to your eye care provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your eye care provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your eye care provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your eye care provider if you have questions.