Iridocyclitis is simultaneous inflammation of the iris and ciliary body. There are many causes and specialist treatment is always required. Visual impairment and even total blindness are a consequence of iridocyclitis without early healing.
What is iridocyclitis?
Iridocyclitis is an inflammation inside the eye. It affects the iris on one side and the ciliary body on the other. This is a ring-shaped structure that serves as a suspension for the iris on the one hand, and on the other hand manages lens accommodation (adjustment of visual acuity) with a muscle that is also ring-shaped. The iris has its own muscle structures and functions like the diaphragm of a camera. Due to the close anatomical connection of the iris with the ciliary body, inflammations of both organs usually occur in combination. Therefore, by definition, there is a compact clinical picture called iridocyclitis.
Causes
As an inflammatory disease, iridocyclitis is basically due to two causes:
1. infections caused by bacteria or viruses. Infection with gonococci (“gonorrhea“) or with herpes viruses (herpes simplex or herpes zoster: “shingles“) affect the region of the anterior and posterior chamber of the eye. Very rarely, infections with the bacterium Leptospira are the cause (Weil’s disease). 2. non-infectious causes. Very different triggers play a role here. Irritant chemicals are known to be an agent, however, underlying systemic diseases are much more often the cause of iridocyclitis. A number of autoimmune rheumatic diseases result in ocular irritation. Juvenile arthritis and chronic intestinal inflammation (Crohn’s disease) are known triggers, as are diseases of the connective tissue such as sarcoidosis and Sjögren’s syndrome. Ankylosing spondylitis is probably also caused by an autoimmune disorder. This disease, primarily of the spine, is also a trigger of iridocyclitis.
Symptoms, complaints, and signs
Characteristic symptoms of iridocyclitis include visual disturbances and eye pain. Affected individuals suffer from excessive sensitivity to light and perceive double vision. Depending on the type and severity of the eye inflammation, other visual disturbances may occur, for example, veil vision or partial visual field loss. In severe cases, temporary blindness occurs in one or both eyes. Externally, the disease can be recognized by changes in the color of the pupil. Adhesions between the iris and cornea indicate iridocyclitis. A clear sign is the deposition of protein in the area of the cornea. The pupil reacts to movements in a slowed manner, often the gaze appears disoriented. Usually, both eyes are affected by the adhesions and reaction disorders. At the beginning, however, iridocyclitis occurs only on one side. If no treatment is given, the damage to the ciliary body progresses until finally the entire eye shrinks. The result is blindness of the patient. If the disease is detected and treated early, serious complications can be prevented. The symptoms then subside after a few weeks without the affected person having to fear long-term consequences or further complications.
Diagnosis and course
Iridocyclitis causes painful eyes and patients become overly sensitive to light so that they feel easily blinded. There is also visual disturbance. With an ophthalmoscopy the specialist recognizes the typical picture with a clouding of the aqueous humor. It is also possible that an adhesion between iris and cornea or even the lens has already occurred. If it has come so far, both eyes will already be affected, because initially an iridocyclitis starts only on one side. Treatment by the ophthalmologist can now prevent possible serious consequences of iridocyclitis. Thus, not only can calcium infiltrate the cornea, but also glaucoma and cataract (cataracta complicata) can occur. When the ciliary body is damaged to the point that it no longer secretes aqueous humor, the entire eye begins to shrink. In the course of such a development, blindness is ultimately a consequence of iridocyclitis.
Complications
Iridocyclitis usually causes discomfort to the eyes. In most cases, those affected suffer from visual complaints and visual impairment.Furthermore, complete blindness of the patient may occur without treatment. It is not uncommon for visual complaints to lead to depression and other psychological upsets, especially in young patients. The patient’s quality of life is significantly reduced by iridocyclitis. In some cases, the affected person is then dependent on the help of other people in everyday life. A high sensitivity to light also occurs. Not infrequently, the reaction of the pupil is also slowed down and there is also pain in the eyes. It is not uncommon for the eye pain to spread to other areas of the body, causing pain and various discomforts. Iridocyclitis is usually treated by an ophthalmologist and does not lead to further complications. In this case, the affected person is dependent on taking medications. These can lead to side effects in some patients. Life expectancy is not affected by iridocyclitis. In some cases, it is also necessary to take antibiotics.
When should you see a doctor?
If symptoms such as eye pain, sensitivity to light or visual disturbances are noticed, a doctor should be consulted in any case. If the symptoms occur quite suddenly and have not subsided after a week at the latest, it is best to consult the family doctor. A doctor should be consulted on the same day if further symptoms occur, such as adhesions between the iris and cornea or changes in the color of the pupil. At the latest, if the vision decreases or even complete blindness occurs, medical advice is needed. The disease can be treated well if it is recognized and treated at an early stage. Persons suffering from the above-mentioned complaints are best advised to consult an ophthalmologist or a general practitioner. Iridocyclitis occurs mainly in connection with viral infections and after contact with irritating chemicals. Chronic intestinal inflammations such as Crohn’s disease and diseases of the connective tissue such as sarcoidosis can also cause the symptoms. Anyone who belongs to these risk groups should consult the appropriate physician if symptoms are mentioned.
Treatment and therapy
Iridocyclitis requires different causal therapies depending on the cause. If underlying systemic diseases are present, your appropriate specialist must be consulted. For noninfectious inflammatory triggers, this will usually be the rheumatologist. The ophthalmologist (eye specialist) treats the symptoms in the eye with glucocorticoids. These cortisone-like drugs have an anti-inflammatory effect and are initially applied as eye drops. If this does not lead to success, the preparations are applied as oral medication. Immunosuppressants, which are an alternative to hormone preparations, are also suitable for reducing inflammatory reactions. This is because glucocorticoids cause severe side effects, including those eye diseases that are supposed to be prevented. As a further medication, the patient receives eye drops that cause temporary dilatation of the pupil. This effect – of atropine, for example – is to keep the iris moving and not sticking to the lens or cornea. In infectious iridocyclitis, the physician must fight the pathogens. Antibiotics target invading bacteria and antivirals inhibit viral replication. General relief is provided by infrared irradiation for iridocyclitis.
Outlook and prognosis
The prognosis of iridocyclitis depends on the causative disorder. If the affected person was exposed to irritating chemicals, spontaneous healing occurs within a short time in most cases. A physician is not needed in these situations. In the future, protective measures for the eye should be increased or the affected environments should be avoided. In the case of an infection by viruses or bacteria, the existing symptoms increase without medical care. The pathogens multiply and can spread further in the organism. In people with a weakened immune system, a spread of the inflammation is to be expected. There is a risk of reduced vision and, in exceptional cases, blindness of the affected person. If drug treatment is initiated in time, relief of the symptoms is documented. As soon as the medication shows its effect, the germs die and are removed from the organism on their own. At the same time, a regeneration process takes place. This minimizes the existing complaints and gradually initiates recovery.The prognosis in these cases is favorable. Nevertheless, viruses or bacteria may reoccur in the course of life. The disease can break out again at any time. The prognosis in the event of a re-infestation of the pathogens remains favorable as soon as medical treatment is given early.
Prevention
Preventing iridocyclitis generally and specifically defies simple measures. If the above-mentioned underlying systemic diseases are detected, the ophthalmologist should be informed about them on the occasion of the routine check-up. As an informed patient, everyone should keep in mind that infectious diseases tend to spread throughout the body. Those who also take care of their eyes are well advised to do so. If complete prevention is not possible, then very early treatment of iridocyclitis is.
Aftercare
In iridocyclitis, affected individuals usually have no or very few options for direct aftercare. First and foremost, a physician should be consulted very early in this disease to prevent further complications or discomfort. Early detection of the disease has a very positive effect on the further course of the disease and can also prevent a further worsening of the symptoms. n most cases, patients are dependent on taking various medications and furthermore on the use of eye drops. The doctor’s instructions should always be followed. The medication should be taken in the correct dosage and, above all, regularly. In the case of antibiotics, care should be taken not to take them together with alcohol. Likewise, regular checks and examinations by a doctor are necessary in the case of iridocyclitis, so that damage to the eyes can be detected and treated at an early stage. As a rule, self-healing cannot occur. The further course is strongly dependent on the time of diagnosis, although life expectancy is usually not reduced by iridocyclitis.
What you can do yourself
Iridocyclitis definitely requires medical treatment. The individual symptoms can be relieved by some self-help measures and home remedies. First, measures should be taken to counteract the sensitivity of the eyes to glare. This can be done by darkening one’s home, wearing dark sunglasses outdoors and not looking directly into the sun or bright lights. If possible, work on computer screens should be avoided, as should reading or watching television. Contact lenses may be reinserted only after consultation with the physician. The physician will recommend that the patient switch to glasses until the condition has completely resolved. In general, iridocyclitis is best treated by following the ophthalmologist’s instructions. Prescribed eye drops should be used as directed and supplemented with oral medication if needed. Home remedies should not be used initially, as they may further stress the eye. Only after the disease has subsided may cooling compresses or masks be used to support aftercare. These measures should also be discussed with the ophthalmologist beforehand.
