Iritis: Causes, Symptoms & Treatment

Iritis is the name given to inflammation of the iris. In this case, the affected person suffers from eye pain and vision problems.

What is iritis?

By iritis, medical professionals mean an inflammation of the iris. Iritis is a form of uveitis (inflammation of the vascular membrane) in which there is inflammation of the middle skin of the eye (uvea), whose components include the iris in addition to the choroid and the ray body. Iritis is characterized by eye pain and blurred vision. Iris can appear at any age. In Germany, approximately 100,000 people per year are affected by inflammation of the median eye skin. The occurrence of iritis is possible in only one eye as well as in both eyes. Whether the symptoms start suddenly or develop gradually depends on the diseased section of the eye.

Causes

In most cases, iritis is caused by a bacterial infection such as a chlamydia, yersinia, or borrelia infection. However, the reason for the inflammation of the iris is not the direct infestation with germs, but the initial infection with the pathogens. Thus, the human immune system is called on the scene, which leads to an immune activation of the body. After its completion, an inflammatory reaction of the iris occurs. During this process, the iris gives a kind of response to the body reaction. Diagnosis of iritis by a smear test is then not possible because the germs are located in another part of the body. In some cases, no cause for the inflammation can be determined at all because the germs have already been rendered harmless. An immune response is therefore no longer necessary. However, it is not uncommon for iritis to be caused by other reasons such as an autoimmune reaction or rheumatic diseases. These include ankylosing spondylitis, arthritis, inflammation of the tendon insertions (enthesiopathy), tenosynovitis, rheumatic fever, inflammation of the spine, or early polyarthritis (Still’s disease). The originators of iritis also include certain herpes viruses. These can cause herpes simplex or herpes zoster (shingles). Other possible originators of irritis include sarcoidosis (Boeck’s disease) and toxoplasmosis.

Symptoms, complaints, and signs

The symptoms of iritis can vary and depend on the number of layers of the eye affected. However, typical features include the appearance of a veil in front of the eye, the sensation of a foreign body, severe sensitivity to light, a reddened eye that tears profusely, and eye pain. If the inflammation moves to the back of the eye, this leads to problems with visual acuity, which in turn reduces the eye’s visual acuity. Some patients also have the sensation of seeing small “clouds.” If iritis is associated with a disease of the spine, this usually leads to an acute course of the disease. These acute cases account for approximately 75 percent of all cases of iritis. The affected persons suffer from a pronounced visual impairment, considerable pain and redness. If iritis persists for a longer period of time, there is a risk that the iris and the lens of the eye will become stuck together, resulting in a chronic reduction in vision. The development of secondary glaucoma is also possible. In some cases, however, iritis temporarily causes no symptoms at all. This is often the case in children suffering from rheumatic diseases. Sometimes the symptoms appear in both eyes.

Diagnosis and course of the disease

If iritis is suspected, an ophthalmologist should be consulted quickly. This deals first with the medical history of the patient. In doing so, he or she is particularly interested in the patient’s previous illnesses. The next step is to examine the eye with a slit lamp. Here, the middle and anterior eye membranes as well as the posterior eye area are examined by illumination. Another important diagnostic method is funduscopy (ophthalmoscopy). This procedure gives the ophthalmologist the opportunity to visualize and examine the diseased sections of the eye. The adjacent blood vessels can also be recorded in this way. The ophthalmologist also performs tonometry to determine the pressure in the eye.This method can be used to exclude possible secondary glaucoma. Because there is direct contact between the eye and the measuring device, the patient receives a local anesthetic. It is also useful to measure the erythrocyte sedimentation rate in order to obtain information about possible previous diseases. Acute iritis can usually be treated successfully after a short time, so that the inflammation recedes. In some cases, however, chronic inflammation may remain. In addition, a return of iritis is conceivable.

Complications

Iritis causes severe discomfort to the eyes in most cases. Those affected suffer from visual discomfort and also eye pain. Especially in young people, visual complaints can lead to depression or other psychological upsets. In the worst case, this can lead to a complete loss of vision and thus to blindness. Patients also suffer from so-called veil vision. The sensitivity of the eyes to light also increases significantly, resulting in restrictions and discomfort in the daily life of the affected person. It is not uncommon for the eyes to become red or watery. The eyes quickly become tired, so that normal work is no longer possible for the affected person. If iritis is not treated, irreversible damage to the eyes can occur, resulting in permanent vision problems. Glaucoma may also occur. However, iritis does not limit or reduce life expectancy. There are no particular complications during treatment. Iritis can be treated with the help of medications or ointments. It is not uncommon for patients to develop iritis again during their lifetime.

When should you go to the doctor?

Eye pain, red eyes, and other symptoms of iritis should be evaluated by a doctor immediately. Reduced visual acuity or a foreign body sensation in the eye are also typical warning signs that should be evaluated and treated by a physician. Patients who notice signs of glaucoma or have other eye complaints are best to speak with an ophthalmologist immediately. However, sometimes iritis can be asymptomatic and resolve on its own after a few weeks or months. A doctor should be consulted if vision suddenly worsens or if blurred vision recurs. Individuals infected with Borrelia or Chlamydia are particularly susceptible to developing iritis. Patients with rheumatic diseases or an autoimmune disease also belong to the risk groups and should have the symptoms mentioned clarified quickly by a medical professional. The right contact person is the family doctor or an ophthalmologist. In the case of existing diseases, the relevant specialist should be consulted.

Treatment and therapy

Treatment of iritis initially consists of the administration of anti-inflammatory drugs. These are cortisone-free anti-inflammatory drops or ointments. However, some physicians also immediately administer eye ointments that contain cortisone. The use of a pupil-dilating drug is also important to prevent adhesion.

medication to counteract adhesion between the iris and lens. If iritis is severe, higher doses of cortisone must be administered in the form of tablets. In some patients, the ophthalmologist also injects the cortisone under the conjunctiva of the eye. If the inflammation of the iris takes a relapsing course, the patient must take the cortisone preparations permanently and in low doses. This procedure is intended to prevent possible relapses. If bacteria are responsible for the outbreak of iritis, the physician administers antibiotics.

Outlook and prognosis

The prognosis of iritis is favorable when medical care is sought. The administration of medications kills the pathogens and germs present. They are then cleared from the body. The discomfort minimizes until recovery occurs. Without the help of a doctor or the use of medicines, the symptoms are likely to increase. Pain increases and vision is reduced. In particularly severe cases, blindness of the affected person occurs. Irreparable damage to the eye can occur with this disease, which does not lead to a complete cure even with subsequent medical care.Visual acuity is impaired and may lead to a need for the use of visual aids. Despite the fundamentally favorable prognosis, the disease may recur in the course of life. The prospect of recovery remains unchanged in the case of recurrent iritis. The sooner treatment takes place, the better the healing process as well as the probability of becoming symptom-free. If vision is already diminished, more complications are documented. A further decrease of vision is possible. In addition, secondary diseases can occur. In most cases, these are psychological diseases that arise due to the mental stress.

Prevention

There are no measures with which iritis can be prevented. Regular checkups by an ophthalmologist are important.

Aftercare

In most cases, the possibilities of direct aftercare for iritis are very limited, so that the person affected by this disease is primarily dependent on a quick and, above all, early examination and treatment by a doctor. This is the only way to prevent further complications or other ailments, so a doctor should be consulted at the first signs of iritis. As a rule, self-healing cannot occur. Most people affected by iritis are dependent on taking various medications. Those affected should always pay attention to the correct dosage and continue to take the medication regularly in order to alleviate the symptoms properly and permanently. If there are any uncertainties or questions, a doctor should always be consulted first so that no further complications arise. When taking antibiotics, it should also be noted that they should not be taken together with alcohol, otherwise their effect will be reduced. The further course of the disease is strongly dependent on the time of diagnosis, so that a general prediction is usually not possible. In most cases, this disease does not reduce the life expectancy of the affected person.

Here’s what you can do yourself

Iritis requires medical treatment in any case. Accompanying the respective therapy, various home remedies and self-help measures are offered. First, the healing of iris can be promoted by increased eye hygiene. In the first days after treatment, the affected eye should be spared and protected from irritating influences such as water, dust, heat or intense sunlight. Accompanying this, the eye and in particular the stuck area must be cleaned regularly and freed from residues. The doctor will prescribe special preparations from the pharmacy for this purpose. In addition, some natural remedies and home remedies are also suitable. Particularly effective: the homeopathic preparations Euphrasia officinalis C5, Mercurius corrosivus C5 and Rhus toxicodendron C5. These preparations should be taken three times a day until the inflammation is completely healed. If dry or cold winds are responsible for the inflammation of the iris, the globule Aconitum napellus helps. A proven home remedy are compresses with chamomile or lemon balm. Before using these remedies, consultation with the doctor should be made. The latter can give further tips on the treatment of iritis and monitor the healing of iris dermatitis.