Iritis (eye pain)
Iritis (more correctly classified as anterior uveitis) is an inflammation of the iris. It may include inflammation of the ciliary body (cyclitis), which is located behind the iris. In iritis, small white blood cells from the inflamed area and excess protein that leaked from the small blood vessels inside the eye float into the aqueous fluid between the iris and the cornea. The iris becomes inflamed and is often experienced as a painful red eye.
Posterior uveitis (choroiditis) is a related condition in which the inflammation extends to the retina and choroid.
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There are two types of iritis: acute (nongranulomatous) and chronic (granulomatous).
Acute, traumatic iritis occurs suddenly and is sometimes caused by trauma or injury to the eye. It can be quite painful, but it generally heals on its own within several weeks. This is the most common form of iritis.
Chronic, non-traumatic, and recurring iritis can last for months or years. It responds less readily to treatment than acute iritis and increases the risk of damage to vision. Complications of chronic iritis can include glaucoma, cataracts, cystoid macular edema, corneal calcification, posterior calcification, and possibly blindness. It can be related to a systemic disease or other ocular condition.
Nongranulomatous (acute) Iritis
While acute iritis is often caused by trauma to the eye, it is sometimes difficult to determine the cause. Its most common form is linked to the human white blood cell antigen HLA-B27 gene mutation that is associated with psoriasis, ankylosing spondylitis, inflammatory bowel disease, and reactive arthritis. Environmental factors play an important role in HLA-B27’s capacity to trigger iritis, and bacterial triggers are most strongly implicated.
Examples of the wide range of hard-to-identify causes include treatment with intense pulsed light, a cosmetic iris implant, and dislocation of a posterior intraocular lens.
Granulomatous (chronic) Iritis
Chronic iritis may result from an autoimmune reaction or an immune response to systemic disease such as tuberculosis, Lyme disease, Bechet’s disease, sarcoidosis, lupus, juvenile rheumatoid arthritis, or herpes.
In general, granulomatous conditions are autoimmune-related conditions that make the body more vulnerable to bacterial and fungal infections. Granulomas are immune cells that collect at the location of infection. So, in the case of granulomatous iritis, this massing of immune cells takes place at the iris, causing redness and pain.
When the iris is inflamed, white blood cells (leukocytes) migrate into the anterior chamber of the eye. They can accumulate and adhere between the iris and the lens, causing irritation and inflammation.
Inflammation of the iris region apparently causes the blood-ocular barrier to deteriorate or fail, allowing protein build-up. This condition forces both protein and white blood cells into the aqueous fluid, resulting in the typical iritis symptoms.
- Eye pain
- Throbbing pain
- Light Sensitivity
- The pupil may become smaller in the affected eye
- Blurred or cloudy vision
- Red eye
The causes of iritis may vary; they can be connected to problems or diseases occurring in the eye, or they may be a result of an inflammatory disease in other parts of the body, such as Crohn’s and ulcerative colitis. Physical trauma, autoimmune disorders, chronic systemic inflammation, and infections are all possible sources. However, it is important to know that iritis is most often a symptom of one or more other disease conditions in the body, and it may be the only symptom that is noticeable. Here is a summary of primary causes:
Blunt trauma to the eye (traumatic or nongranulomatous iritis), such as eye and head injury, problems arising from ocular surgery, or eye treatments and therapies
Association with other diseases or disorders (non-traumatic or granulomatous iritis), such as ankylosing spondylitis, sarcoidosis, Reiter syndrome, inflammatory bowel disease, psoriasis, and collagen vascular diseases such as lupus and cancers
Infectious illnesses (non-traumatic or granulomatous iritis), such as Lyme disease, syphilis, herpes simplex and herpes zoster viruses, tuberculosis, and toxoplasmosis
Since the cause of iritis is not known, a very careful medical history needs to be taken. Your doctor may recommend chest X-rays, blood tests, stool evaluation, skin tests or even a spinal tap.
The first line of treatment is usually steroid and non-steroidal anti-inflammatory eyedrops. If the inflammation persists or comes back, your doctor may also inject steroids around your eye or prescribe additional oral steroids, antibiotics, antifungals, or antivirals.
A case of iritis usually lasts six to eight weeks. Make sure your eye doctor monitors your progress carefully. The effects of the medication can be cataracts, glaucoma, corneal changes and possibly more inflammation.
We believe that eye problems such as chronic iritis reflect the health of the whole body. Where there is inflammation in one part of the body, there is often inflammation in another. Therefore diet, nutrition, and lifestyle choices can play a major role in having and maintaining good vision.
Since non-traumatic iritis is typically a symptom of underlying health conditions involving inflammation, augmenting conventional treatments with targeted antioxidants can be essential in helping preserve vision while managing the symptoms of iritis.
Antioxidants are available through a healthy anti-inflammatory and alkalinizing diet as well as through nutritional supplements. They help in a number of ways, including:
- Neutralizing the potentially damaging effects of free radicals that are a by-product of inflammation (particularly chronic inflammation)
- Delivering essential nutrients to all parts of the eyes, which are vital for healthy eyes
- Reducing inflammation (through specific supplements that have natural anti-inflammatory properties)
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Iritis may occur along with a number of other conditions:
- Rheumatoid arthritis is a chronic autoimmune problem wherein tissues surrounding the joints are swollen and inflammed.
- Uveal tract inflammations of other areas of the uvea such as cyclitis and choroiditis
- Behcet's disease - a possible autoimmune disorder in which there is blood artery and/or vein inflammation throughout the body, including the eye.
- Crohn's disease and Colitis are common types of inflammatory bowel disease.
- Graves' disease is an autoimmune condition causing hyperactivity of the thyroid.
- Lupis - another chronic autoimmune condition causing inflammation because immune system becomes over-active and attacks healthy systems.
- Chronic psoriasis - immune system abnormalities or stress-related flare-ups cause severe inflammation and scaly skin cell tissue.
- Gout - painful inflammation resulting from too much uric acid which crystallizes and gathers in joints.
- Lyme disease - a bacteria-caused infection that causes inflammation and pain in joints and can spread to the heart and nervous system.
- Tuberculosis - another bacteria-caused infection that attacks the lungs, especially impacting people with a weak immune system.
- Venereal disease, including syphilis and herpes - sexually transmitted diseases involving a variety of bacteria, viruses, and yeasts.
- Some cancers such as leukemia, lymphoma and melanoma