Iritis also known as Uveitis, is the inflammation of the iris, the coloured portion of the eye. It has been known cause extreme pain, light sensitivity and sight loss, which is often the result of a disease in another part of the body. Most cases of iritis are recurring, in what are small attacks. Once treated the attack will usually respond to various medications. However, the condition may become sight threatening when left untreated. Medication for iritis varies, treatment that works for one will not always work with another.
The uvea, also known as uveal layer, uveal coat, uveal tract, or vascular tunic, consists collectively of the iris, the choroid of the eye, and the ciliary body. Inflammation of the iris (iritis) is the most common type of uveitis.
- The iris – the colored part of the eye that surrounds the pupil.
- The choroid of the eye – the part of the eye between the white of the eye (sclera) and the retina (the light sensing part at the back of the eye). The choroid of the eye is a thin vascular middle layer.
- The ciliary body – a ring of muscle behind the iris; this body of tissue connects the iris with the choroid.
Inflammation of the uvea may be painful. It usually causes a red eye, sometimes with cloudy vision.
An injury to the eye, a viral or bacterial infection, as well as some underlying diseases may cause uveitis. If left untreated the patient may suffer vision loss.
Types of uvetitis / iritis
- Anterior uveitis – frequently termed iritis. This type affects the front of the eye.
- Intermediate uveitis – consists of vitritis, inflammation of the jelly-like part of the eye (vitreous cavity). When there is inflammatory material on the pars plana, the condition is called pars planitis
- Posterior uveitis – inflammation of the retina and choroid. Posterior refers to the back of the eye.
- Pan-uveitis – is when inflammation exists in all layers of the uvea.
Causes
Although eye specialists do not usually know specifically why uveitis occurs, we do know about some situations and circumstances that make its likelihood greater. The following factors may increase the risk of developing uveitis –
- Injury to the eye – Blunt force trauma, a penetrating injury, or a burn from a chemical or fire can cause acute iritis.
- Infections – Shingles (herpes zoster) on your face can cause iritis. Other infectious diseases, such as toxoplasmosis, histoplasmosis, tuberculosis and syphilis, may be linked to other types of uveitis.
- Genetic predisposition – People who develop certain autoimmune diseases because of a gene alteration that affects their immune systems might also develop acute iritis. Diseases include ankylosing spondylitis, Reiter’s syndrome, inflammatory bowel disease and psoriatic arthritis.
- Behcet’s disease – An uncommon cause of acute iritis in Western countries, this condition is also characterized by joint problems, mouth sores and genital sores.
- Juvenile rheumatoid arthritis – Chronic iritis can develop in children with juvenile rheumatoid arthritis.
- Sarcoidosis – This autoimmune disease involves the growth of collections of inflammatory cells (granulomas) in areas of your body, including your eyes.
- Certain medications – Some drugs, such as the antibiotic rifabutin (Mycobutin) and the antiviral medication cidofovir (Vistide) that are used to treat HIV infections, might cause iritis. Stopping these medications usually stops the iritis symptoms.
Risk Factors
People with the following conditions or characteristics are at risk for uveitis:
- Develop a sexually transmitted infection. Certain infections, such as syphilis or HIV/AIDs, are linked with a significant risk of iritis.
- Having infections, such as syphilis, tuberculosis, cytomegalovirus, and Lyme disease
- Having other eye diseases
- Cat owners are at increased risk of toxoplasmosis because cat litter contains spores of the parasite. Pregnant women should not change cat litter.
- People who take certain medications, such as rifabutin (Mycobutin), a type of antibiotic
- Live in certain geographic locations where infectious causes are more prevalent, for instance, in the U.S. in the Ohio or Mississippi river valleys where histoplasmosis — a fungal infection — occurs more frequently.
- Have a compromised immune system or autoimmune disorder.
Symptoms
A symptom is something the patient feels or reports, while a sign is something other people, including a doctor, may detect. For example, a pain may be a symptom while a rash may be a sign.
The signs, symptoms of iritis may include –
- Blurred vision
- Cloudy vision
- Floaters – debris in the eye make you see tiny rods, chains of transparent bubbles floating around in your field of vision
- General vision problems
- Eye pain
- Eye redness
- Photophobia – abnormal sensitivity to light
- Headaches
- A small pupil
- Alteration of the color of the iris
Symptoms can come on gradually or rapidly.
Complications
- Cataracts – Development of a clouding of the lens of your eye (cataract) is a possible complication, especially if people experienced a long period of inflammation.
- An irregular pupil – Scar tissue can cause the iris to stick to the underlying lens or the peripheral cornea, making the pupil irregular in shape and the iris sluggish in its reaction to light.
- Glaucoma – Recurrent iritis can result in glaucoma, a serious eye condition characterized by increased pressure inside the eye (intraocular) and possible vision loss.
- Calcium deposits on the cornea (band keratopathy) – This condition results in degeneration of the cornea and could decrease the vision.
- Swelling within the retina (cystoid macular edema) – Swelling and fluid-filled cysts that develop in the retina at the back of the eye (macular retina) can blur or decrease the central vision.
Treatment
Medications
- Corticosteroids, to reduce swelling and pain. The doctor may prescribe either eyedrops or pills.
- Antibiotics or antiviral medications, depending on what is causing uveitis
- Non-steroidal anti-inflammatory drugs (NSAIDs), to reduce inflammation
- Medications to suppress the immune system, in cases where corticosteroids do not help
Alternative Treatment
Multivitamins – A multivitamin daily, containing the antioxidant vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium. These vitamins and minerals are good for eye health and overall health. One small study suggested that vitamin C and E may help reduce symptoms of anterior uveitis.
Omega-3 fatty acids, such as fish oil, may help lower inflammation and boost the immune system. Cold-water fish, such as salmon or halibut, are good sources. Avoid taking omega-3 fatty acids before surgery for uveitis as they may increase the risk of bleeding.
Lutein is an antioxidant that is important for eye health.
Turmeric (Curcuma longa): Has antioxidant properties and may help boost the immune system.
Reference –
http://www.medicalnewstoday.com/articles/166410.php
http://www.allaboutvision.com/conditions/uveitis.htm
https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/eyes-uveitis-and-iritis
http://www.eyecaretrust.org.uk/view.php?item_id=86
http://www.mayoclinic.org/diseases-conditions/iritis/basics/definition/con-20034315
http://www.medicinenet.com/iritis/article.htm