Iritis: Types, Causes, Symptoms, Diagnosis, and Treatment

What Parts of the Eye Does Iritis Affect?

Iritis affects the iris, the coloured part of the eye and the anterior chamber, which separates the cornea and the iris. The iris is the coloured part of the eye that surrounds the pupil and helps control how much light enters the eye, according to My Health Alberta. The anterior chamber is the space between the iris and the cornea that is filled with aqueous humour. If a person has iritis, it means the iris and possibly the anterior chamber are inflamed.

What Does Iritis Look Like?

Iritis is an inflammation of the iris and the anterior chamber, with parts of the eye likely to look, red and swollen. The conjunctiva and area around the iris may be red and bloodshot and the pupils of the eye may look an abnormal shape. The below image shows what an eye affected by iritis may look like, with the conjunctiva red and inflamed and the pupil abnormally shaped.

What is the Other Term for Iritis?

The other term for iritis is anterior uveitis, which refers to the inflammation of the anterior chamber as well as the iris. The anterior chamber is the space between the cornea and the iris.

1. Chronic Iritis

Chronic iritis refers to iritis that persists or is frequently recurring. According to Gurnani B, Kim J, Tripathy K, et al, in the paper Iritis the symptoms of chronic iritis include mild redness, blurred vision, some pain and photophobia.

2. Acute Iritis

Acute iritis refers to iritis in which symptoms develop quickly over the course of a few hours and days, and is ultimately resolved quickly. According to the American Academy of Ophthalmology, acute iritis is characterised by a sudden onset of symptoms that lasts for a limited duration. Symptoms of acute iritis include redness, pain, photophobia and decreased vision, according to Gurnani B, Kim J, Tripathy K, et al, in the paper Iritis.

1. Certain Drugs

Certain drugs or medications can cause iritis as they may lead to inflammation in the eye. According to Iqbal KM, Hay MW and Emami-Naeini P. in the paper Medication-induced Uveitis: An Update drug induced ocular Melanoma is rare but can occur. Some medications may cause ocular inflammation if they are not the right medication for a patient's issue, or if the patient has a reaction to the medications. This inflammation may occur in the iris or anterior chamber, leading to iritis. Medications that may cause iritis include intraocular injections and topical medications.

2. Health Problems

Certain health problems may cause iritis if they affect the structures of the eye, including Kawasaki syndrome and leukaemia. According to Health Direct, Kawasaki syndrome is a rare condition in which the blood vessels swell. According to the American Academy of Ophthalmology, anterior uveitis, or iritis, is an early clinical sign of Kawasaki syndrome and is present in 70% of patients.

3. Eye Infections

Eye infections, including viral infections and bacterial infections, can be a cause or iritis. If an eye infection affects the structures and tissues within the eye, it may cause inflammation within the iris or anterior chamber leading to iritis. Inflammation is one of the body’s immune responses to fight this infection.

4. Behcet's Disease

Behcet’s disease is an autoimmune disease in which blood vessels and tissues become inflamed, and can potentially cause iritis if this inflammation affects the structures of the eye. According to the American Academy of Ophthalmology, Behcet’s disease is a systemic vascular disease that involves the inflammation of blood vessels and tissues. If Behcet's affects the structures of the eyes, this can lead to inflammation of the iris or anterior chamber, or iritis.

5. Eye Injury

An eye injury can be a cause of iritis if the injury causes inflammation in the iris or anterior chamber. An eye injury refers to an injury to the eye, including blunt trauma directly to the eye or the orbital bone, foreign bodies in the eye or chemical splashes. After an eye injury, such as blunt force trauma to the eye, the iris may become inflamed in response. Iritis that is caused by trauma to the eye is referred to as traumatic iritis, according to the American Academy of Ophthalmology.

6. Juvenile Idiopathic Arthritis

Juvenile idiopathic arthritis is a type of arthritis that affects children under 16 and may cause uveitis, which can include iritis. According to the American Academy of Ophthalmology, juvenile idiopathic arthritis is characterised by arthritis affecting those under 16 that lasts for at least 6 weeks. According to Heiligenhaus A, Minden K, Föll D and Pleyer U in their paper, Uveitis in juvenile idiopathic arthritis, juvenile idiopathic arthritis is one of the most common causes of uveitis in children, with a prevalence of 10 per 100 000 people. If a person has juvenile idiopathic arthritis that causes uveitis, this inflammation may include or be focused on the iris, which would be considered iritis.

7. Sarcoidosis

Sarcoidosis is an inflammatory disease in which sarcoid granulomas develop in different parts of the body including the lungs, lymph nodes, skin and eyes, which may lead to uveitis and iritis. Granulomas are immune system cells that clump together according to Health Direct. Granulomatous anterior uveitis, which is another name for iritis, is the most common orbital manifestation of sarcoidosis, according to the American Academy of Ophthalmology.

How Common is Iritis?

Iritis is the most common type of uveitis and occurs in every 12 per 100,000 cases, according to an article published in the National Library of Medicine. Acute iritis is also the most common clinical presentation of this eye condition.

Who Commonly Develops Iritis?

Iritis is more commonly developed in males than females, according to a 2015 article titled, The Role of sex in uveitis and Ocular Inflammation, published in the National Library of Medicine.

1. Eye Pain

Eye pain is a possible symptom of iritis due to the inflammation in the eye, and the underlying cause of the iritis. Eye pain can refer to several feelings in or around the eye such as a sharp pain, an ache or a burning feeling. Iritis may cause eye pain due to the inflammation of the iris or anterior chamber of the eye, as well as any surrounding structures, depending on the cause of the iritis.

2. Blurry Vision

Blurry vision may be a symptom of iritis, caused by the inflammation in the iris and how this affects the way it operates. The iris is the coloured part of the eye that helps a person see by regulating the amount of light that enters the pupil, according to the National Eye Institute. If a person has iritis, the inflammation of the iris structure may affect how this process works. causing blurred vision.

3. Light Sensitivity

Light sensitivity, also known as photophobia, may be a symptom of iritis, caused by inflammation. One of the main functions of the iris is to regulate the amount of light that enters the pupil, according to the National Eye Institute. If a person has iritis, the inflammation may affect how light is received by the eye, causing light sensitivity.

4. Redness Around the Iris

Redness around the iris is a possible symptom of iritis, caused by the inflammation this condition causes in the eye. Iritis refers to inflammation in the iris or the anterior chamber. Inflammation is characterised by redness, swelling and irritation, which can manifest around the outside of the iris.

5. Pupil That is Abnormally Shaped

A pupil that is abnormally shaped is a possible symptom of iritis if the iris has stuck to the lens of the eye. The pupil is the opening in the middle of the iris that lets light into the eye. If a person has iritis, the iris, the coloured part surrounding the pupil, is affected. According to the NHS Moorfields Eye Hospital, if a person has iritis the iris may stick to the lens of the eye, which can cause the pupil to look abnormally shaped.

6. Tearing

Tearing can be a symptom of iritis due to the inflammation of the iris and anterior chamber. Tearing refers to the eye producing an excess tears. Iritis can cause increased tear production, often to combat the symptoms of inflammation, with the increased production in tears to help relieve the symptoms of eye inflammation symptoms such as itching or burning.

7. Vision Loss

Vision loss, or decreased vision, may be a symptom of iritis. Iritis refers to inflammation in the iris, which is a structure in the eye that helps a person see by controlling the amount of light that is let into the eye. If a person has iritis, the inflammation may cause issues with how the structures of the eye work, leading to vision loss or decreased vision.

8. Headache

A headache may be a symptom of iritis. If a person has iritis, this means the iris is inflamed and may be accompanied by symptoms such as eye pain, light sensitivity, vision loss and tearing, all of which can potentially trigger a headache.

What are the Eye Tests for Diagnosing Iritis?

The eye tests performed to diagnose iritis include a visual acuity test, an external examination and a slit lamp test, according to the Mayo Clinic. Eye tests will be conducted to assess a patient's symptoms and examine the iris and anterior chamber of the eye. An optometrist administers a visual acuity test to assess the sharpness and clarity of a person’s vision. An external examination looks at a patient’s pupil, often using a penlight to identify any signs of redness in the eyes as well as check for discharge. A slit lamp test examines the different structures of the eye using a microscope with a bright light. It is used to view inside the patient’s eyes for signs of iritis.

What Might Happen if Iritis is Left Untreated?

If iritis is left untreated, it may lead to the eye condition glaucoma or eventual vision loss. Other complications of untreated or improperly treated iritis include cataracts and an irregular pupil. It is important to seek attention from an eye care professional if you suspect you have iritis as they can provide diagnosis and treatment.

What are the Complications of Iritis?

Complications can arise if iritis is not treated properly or at all. The complications of iritis, according to the Mayo Clinic, include cataracts, glaucoma, an irregular pupil and swelling in the retina. These complications of iritis and their definitions are listed below.

• Cataracts: Cataracts is an age-related eye condition that causes the opacification of the lens, also known as clouding of the lens. Cataracts can develop if iritis is not treated, especially if there is a long period of inflammation.
• Glaucoma: Glaucoma is a term used to describe a group of eye conditions that cause vision loss due to optic nerve damage. Glaucoma may be a complication of recurrent iritis.
• Irregular pupil: Untreated or improperly treated iritis can cause an irregular pupil as scar tissue affects the lens or cornea, leading to the pupil appearing irregular and the iris becoming sluggish in terms of its reaction to light.
• Swelling in the retina: Swelling of the retina may be a complication of iritis. The swelling is caused by cysts filled with fluid that develop in the retina which can decrease or blur central vision.

How to Prevent Iritis?

There is not a simple solution for how to prevent iritis as it cannot necessarily be prevented. However, according to Cedars Sinai Health Organisation, it is important to see an optometrist at the first signs of iritis symptoms or any other eye-related issues as early detection is important for the treatment of eye diseases.