What Is Iritis, and How Is It Treated?

Question: I’ve had iritis now for the past two years. Is it a form of arthritis? I have been using a steroid drop (prednisolone) in my eyes as much as six drops two as low as two a day in one eye.

Every time my doctor reduces the dosage, I have a flare up. Is there any other form of treatment? Can it be cured? And most importantly, what causes this condition and is there any research being done?

Dr. Hibberd's Answer:

Iritis is the medical term for inflammation of the iris, the pigmented tissue that gives our eyes their color. It is in front of the lens and behind the clear cornea at the front of our eye and serves as a type of shutter mechanism to adjust the amount of light that enters the eye.

Inflammation produces pain, decreased vision, redness and intense sensitivity to light (photophobia).

Many cases have no known cause. When an infectious or autoimmune cause is evident, it is important to treat the underlying disorder to prevent the recurrence or persistence of iritis. Iritis may be associated with joint inflammation (arthritis) and is often seen in conjunction with various disorders that cause arthritis.

While the iritis itself does not cause arthritis, an underlying disorder is often found that triggers both conditions.

Left untreated, iritis can be serious and can cause scar tissue that is difficult to treat and can result in permanent complications including loss of vision. Initial treatment is often topical medications (steroids and drops to dilate the eye), and treatment of the underlying disorder. Immune suppressants are often needed in recurrent cases, since many of these are caused by an autoimmune disorder.

Iritis can be caused by trauma, and should be treated without delay. Untreated trauma to the iris of one eye can actually set up an immune reaction that may stimulate attack on the iris of the unaffected eye resulting in permanent vision loss in both eyes!

If you think you may have iritis, see your opthamologist without delay or go to the emergency department of your nearby hospital.

Recurring iritis suggests there is underlying disorder that should be investigated. I am not happy to see your therapy consists of only steroid eye drops. See your opthamologist and your primary care physician to begin your workup, but if no cause is found, request a referral to a rheumatologist and an infectious disease specialist for further consultation.

Recurrent iritis usually has an identifiable precipitating condition that can be treated to reduce recurrent attacks.