Iritis – Minor Irritation or Major Warning?

iritis-eyeIritis is a common diagnosis that literally means “inflammation of the iris,” the colored part of the eye. Anterior uveitis is a more technical term for iritis. There are many possible causes, and sometimes the cause cannot be identified. Due to the complexity of the vision system, any suspected case of eye inflammation should be examined by an optometrist, ophthalmologist or medical doctor. Most of the time, iritis resolves in less than 6 weeks; however, iritis can reoccur. It can signal  acute or chronic underlying disease in the body, and therefore should be cared for by a qualified healthcare professional. Without proper treatment, iritis can lead to cataracts, glaucoma, an irregularly sized and sluggish pupil, calcium deposits in the cornea, central serous choroidopathy, or retinal swelling (cystoid macular edema). 

Leading Cause of Blindness

Iritis is the most common form of uveitis, a condition involving one or more of the three structures that comprise the intricate uvea. The iris is the front part of the uvea, the middle layer is the ciliary body  (fine muscles that focus the eye) and at the back of the uvea is the choiroid which holds the small blood vessels that deliver nutrients and oxygen to the eye tissues.  Although iritis is usually not serious, uveitis has the unpleasant distinction of being the third leading cause of blindness in developed nations due to its being a contributing factor to other serious vision conditions.

How Iritis Is Diagnosed

Symptoms of iritis include redness, pain in the eye, sensitivity to light (hyperphobia), tearing (excess moisture in the eye), cloudy or blurred vision, and/or red eye. The iris is composed of muscular fibers that make the pupil contract or enlarge, to allow the optimal amount of light into the eye. If one eye has iritis, the affected pupil may appear smaller than the healthy eye.

A vision professional can diagnose iritis. The Edinburg Red Eye Diagnostic Algorithm is a tool used to determine whether a patient with red eye is suffering from simple conjunctivitis or something more serious. It has a 76% accuracy rate – iritis (82%), acute angle glaucoma (100%), stromal keratis (63%), epithelial keratis (70%), and conjunctivitis (50%).

Diagnosing the underlying cause of iritis can be more involved, due to the number of possible causes.

Causes

  • injury or trauma
  • autoimmune disorders
  • infections
  • side-effect of certain medications
  • certain cancers
  • other or unknown reasons

Injury or trauma to the eye can cause acute iritis. This could be from an accident, such as a heat burn, chemical burn, blunt force, or eye injury.

Autoimmune disorders can cause iritis. Some individuals have a genetic predisposition to autoimmune diseases including inflammatory bowel disease, ankylosing spondylitis, Reiter’s syndrome, and psoriatic arthritis. Also, people with sarcoidosis and children with juvenile rheumatoid arthritis can develop iritis.

Infections such as a shingles outbreak on the face can inflame the iris.

Side-effect of certain medications can include iritis, such as an antibiotic called rifabutin (Mycobutin) for treating tuberculosis, and an antiviral medication called cidofovir (Vistide) used by HIV patients to treat an infection of retina, cytomegalovirus (CMV) retinitis.

Cancers – Iritis can be one of the symptoms of some cancers where serious infections arise due to the weakened immune system. Conversely, treatments for cancers such as melanoma can cause iritis.

Complications – Iritis develops in about 12% of patients receiving an artificial lens after cataract surgery and 10% of patients receiving an implanted miniature telescope in the eye.  Treatment for advanced AMD with bevacizumab injections has been known to cause iritis.  Cosmetic iris implants can cause iritis.

Other conditions – the list of other conditions associated with iritis is lengthy and includes AIDS, Behcet syndrome, cutaneous leukocytoclasic vasculitis (purple skin lesions), retinitis, herpes, histoplasmosis (especially in the midwest), Kawasaki disease, psoriasis, syphilis, tuberculosis, and colitis.

Prognosis and Treatment

Although iritis usually heals by itself after several weeks; it can recur again and again over months or years.  After initial assessment, your doctor may recommend chest x-rays, blood, stool and skin testing and perhaps even a spinal tap.  The introduction of steroids in the 1960s contributed to a significant advance in the treatment of iritis and uveitis – but at a cost.

  1. Steroids increase your sensitivity to light making you more susceptible to glaucoma and cataracts
  2. Corticosteroids can trigger central serous choroidopathy (a sudden onset of blurry vision due to fluid leaking into the tissues around the retina and causing pressure).
  3. Steroids increase intraocular pressure making you more vulnerable to glaucoma and optic nerve damage.

In the late 1970s the search for less toxic treatments than steroids led to the development of immunosuppressive drugs such as antimetabolistes, T-cell inhibitors, and alkylating agents.1

Complementary Therapy

First, it is important to make certain that your iritis is not a symptom of or associated with a more serious health condition.  Complementary treatment alone may not be sufficient to treat uveitis.  However, depending on the cause, some nutrients, herbs and supplements may be helpful and support good underlying vision health.

According to the University of Maryland Medical Center, these nutrients are important:

  1. A good multivitamin daily. We recommend the Advanced Eye & Vision Support Formula which specifically targets vision health and the BioMax Food Multi III (whole food, organic multivitamin).  Both are formulas which derive from whole foods rather than synthetic extracts.
  2. Essential fatty acids. The omega-3 fatty acids are well known to support vision health (as well as heart health and brain functioning).  Omega-3s that come from low on the food chain are likely to have fewer toxins like mercury which are accumulate in the fish body.  We recommend Premium Krill Complex which includes astaxanthin, an essential antioxidant for the eye and natural anti-inflammatory.  Note that if you are taking a blood thinning medication you should check with your doctor before taking Omega-3s – since they have a slight blood thinning effect.
  3. Lutein, zeaxanthin, astaxanthin,  (found in plant pigments), enzymes such as glutathione and super oxide dismutase, and nutrients such a CoQ10 and alpha lipoic acid (which increases glutathione) are important.

In addition, these are also recommended.

  1. MSM in capsules or powder – natural anti-inflammatory
  2. Serrapeptase – enzyme taken on an empty stomach that helps break down debris in blood and tissue that can contribute to chronic inflammation.
  3. Digestive Enzymes – taken with meals.

You can call us at 845.255.8222 for a free consultation if you have questions.

Learn More

Learn more about ititis and uveitis

Learn more about our vision protection protocol – lifestyle, activity and diet to support your previous vision.

Footnote:

  1. Sangwan, V.S., Treatment of Uveitis: Beyond Steroids, Indian Journal of Ophthalmology, 2010 Jan-Feb; 58(1): 1–2.
Summary
Article Name
Iritis - Irritation or Warning?
Description
The red eye, irritation and sometimes pain of iritis may be a discomfort which heals itself in several weeks, or may be an warning sign of something more serious.