Iridocyclitis and Uveitis – Symptoms Causes and Treatment
Introduction & Definitions
Iridocyclitis is a disease of the iridium (lining the iris) and the ciliary muscle (the soft muscle that supports the iris). Iridocyclitis is also known as iritis, and inflammation of iridium alone is often referred to as iridocyclitis. Other forms of iritis include polymyalgia rheumatica, and erythema migrans. The word “iridotomy” refers to a surgical procedure for the removal of iridometamen. “Ciliary artery surgery” refers to surgery for the treatment of erythroderma migrans.
Iridocyclitus, more commonly known as: Uveitis or Iritis; Uvular Cystitis; Ankylosing spondylosis; or simply “Canker”. Iridocyclitus (ear-ee-uh-tys) is inflammation of your iris and other body structures, usually the ciliary body and/or iris, in the middle layer of your eye. The word “iridocycle” comes from the Greek words “ir” meaning “water” and “ocycle” meaning “worm”. The majority of cases of iridocyclitis are acute, and symptoms clear up within a day or two, although in some rare cases symptoms can persist for weeks or months. The majority of cases of iridocyclitis are of the non-hereditary type and is also often referred to as “chronic ankylosing spondylosis”.
Inflammation of the iridocyclitis is the most common condition in which the iris is inflamed. Iridocyclitis can also be described as: Uveitis; Iritis; Anterior Uveitis. This condition can affect any area of your eye from upper eyelids to the bottom corner of your eyes. May also be known as: Uveitis; Iritis; Anterior Uveitis
Examining
The iridoscope is a tool used to examine the inner lining of irises; the name comes from the curved shape of its probe. The examination of the iris is performed with the patient lying on his back; hence the name “iridocyclitus”. With the help of an iridoscope, doctors can see into the innermost layer of the eyelid. It is the ciliary body that provides the drainage of fluids from the eye to the retina. The delicate cilia are covered with a thin membrane called the iritis.
Causes
Many factors are involved in determining the exact cause of iridocyclitis. Iridocyclitis often occurs when there is an infection in the choroid, a collection of blood vessels that supply the iris. Other possible causes include erythema multiforme and primary iritis.
The primary cause of the crisis is chronic inflammation of iris cysts. In some people, trauma to the eyelids such as a tear or a forehead injury causes an acute inflammatory reaction which results in iris and pupil loss. Another common cause of inflammation is infection, particularly of the macular. Treating iridocyclitis requires surgical intervention to remove the inflamed cilia and remove the irises. This invasive approach is only recommended in cases of severe iritis or primary iritis, in which the iris cysts are likely to be cancerous.
Acute irtis usually follows a bacterial infection (such as Streptococcus pneumoniae). When the bacteria invade the eye, the result is usually iritis, which is characterized by painless discharge. In most cases, writes clears up within a week or two. The exception to this is the case where a bacterial infection has originated in the iris cysts, which may take several weeks before they begin to clear. This is known as iritis chronicus, and it has been shown to occur more often in elderly individuals than in younger people.
The primary cause of the crisis is an increase in intraocular pressure, which is caused by fluid build-up in the anterior chamber of the eye, or iritis. Typically, fluid will buildup behind the retina and then collect in the posterior chamber of the eye. This fluid, due to its high water content, acts as a cushion, preventing pressure from building behind the retina. When fluid builds behind the retina, the iris becomes irritated, and inflammation occurs in the cornea and lens.
The normal physiological process is for the ciliary body to slowly secrete aqueous humor from the iritis into the posterior chamber of the eye. If there is inflammation, this secretion of the ciliary body is increased, which can result in increased pressure being placed on the retina. If the pressure is not decreased, fluid leaks out from the iris into the aqueous humor. When this occurs, a wetting is apparent, followed by a stinging sensation in the eye.
Chronic iridocyclitis is often characterized by redness, warmth, and pain behind the cornea, accompanied by vision loss and halos. This can be a very serious condition, since it can cause damage to the sensitive eyes lining, and even vision loss itself. This form of acute iridocyclitis is usually accompanied by eye pain and inflammation that typically responds to ointment treatment. Oral antibiotics are generally effective in relieving both eye pain and inflammation, but sometimes oral steroids are ineffective or too harsh for treatment. It is very important to follow your eye doctor’s orders for taking and using prescribed treatments until you can be completely healed.
Ciliary body inflammation is another possible cause of iridocyclitis, especially when the body is inflamed (as in arthritis) or injured. The ciliary body is the part of the kidney that collects and disposes of waste products from the bloodstream. If the body is inflamed, it can become infected, which can cause serious medical problems. As noted above, ciliary inflammation can cause halos to appear behind the cornea, but sometimes this does not occur, causing just temporary visual disruptions. In these cases, the iris may appear clear, but infection or irritation is still present.
In rare instances, both conditions can be present at the same time. Rarely, iridocyclitis can be a secondary problem due to other conditions such as iritis, luteinizing hormone (LH), or other diseases. In these cases, iritis is usually the more serious condition, and iridocyclitis just adds to the picture by bringing both conditions together.
The causes of the crisis are many. Infections, injury to the eye, allergic reactions to medications, and surgery to the eyelid or middle ear may cause the iridocyclitis described. The inflammation is typically found in people with critics, who are between the ages of five and twenty-four. It tends to be more severe than iritis in children and adults. It can cause eyelid discomfort and loss of vision. It is the most common cause of an abnormal discharge from the eye.
Effects
The inflammation of irid cysts may affect any part of your eye, but it is quite common that the most common site for inflammation in humans is the irid cyst itself. It extends between the iris and the ciliary body. The ciliary body is a basket-like structure, composed of two small pieces. One piece is longer than the other. The shorter piece, called the carotid artery, supplies blood to the eyelid and the brain.
The abnormal swelling of the iris is caused by an infection in the small pockets within the ciliary body. When iridocyclitis occurs, the inflammation is typically found in the anterior uveitis, or ciliary layer, and is often accompanied by a discharge from the iris. In cases of anterior uveitis, the discharge from the iris may be a creamy white, like hen’s milk, or dark red, like dried blood.
Blurred Vision
Another condition associated with iritis is blurred vision. In cases of iris, the iris may become inflamed, causing blurred vision. Blurred vision in relation to eye movement is called myopia; it is usually accompanied by loss of peripheral vision. Myopia can also produce an increase in the appearance of light beyond the normal range of vision.
Cystadenomas, or cysts, can develop in the ciliary body because of inflammation. Cystadenomas can produce symptoms similar to critics, such as blurred vision, eyelid pain and discharge from the eye. Treatment of iridocyclitis involves removing the cysts. Surgery may be needed if the cyst does not dissolve on its own. Medications such as azathioprine and mercaptopurine are sometimes used to reduce inflammation.
Although iridocyclitis is a disease of the eye, it is also often associated with vision problems such as iritis, which itself can result in blurry vision or other associated problems. When crisis occurs along with iritis, or in the place of crisis, the two can worsen and complicate the underlying crisis. Blurred vision and other associated problems usually occur in the right half of the visual field. In rare cases, the iritis can even damage blood vessels supplying the retina.
Posterior Corneal Louping
In the case of iritis, the physician may perform a posterior corneal louping (PRL) to check for iris or anterior uveitis. A posterior loading involves the use of a small, lighted instrument called a louping instrument to move the iris through the pupil. PRL can also be used to treat iridocyclitis.
Iridotomy and Choroid
As for the pupil, it is divided into two parts: the iridotomy and the choroid. The iridotomy is the opening of a hole through which the iris can be removed. It is done by cutting a small incision inside the iris and pushing it outward. Sometimes, the ciliary body is also affected. A choroid is a bag-shaped structure situated behind the iris and filled with blood vessels that carry it to the retina. If the iris is removed, this is known as ciliary villi iridotomy.
Symptoms
The symptoms of iritis include erythema, blurred vision, eye pain, increased sensitivity to light, decreased vision, and inflammation around the iris or ciliary body. On the other hand, the symptoms of anterior uveitis include redness, swelling, and erythema around the pupils. It is usually caused by trauma, infection, or a foreign body in the nose. Usually, iridocyclitis causes blurred vision, eye pain, decreased vision, and increased sensitivity to light.
Symptoms of iridocyclitis often mirror those of other vision problems, so it’s important to rule out other possible causes of blurred vision, such as corneal edema, retinal infection, gas build-up, or other conditions. Blood tests can help detect iron deficiency, which can lead to iridocyclitis if vision loss is present. Eye drops and oral steroids may also be used to treat iridocyclitis. However, if aqueous humor does not leak from the iris, it is not likely to be caused by iridocyclitis, and antibiotics are ineffective. In these cases, aqueous humor may be present, but the cause is either a bacterial infection or a primary condition such as cataracts.
As with other forms of arthritis, the symptoms of iritis can become more acute with age. The disease can progress from milder forms of arthritis, such as atrophic arthritic change, to the more serious and potentially life-threatening iritis. Blurred vision, extreme eye pain and decreased night vision are all potential early warning signs of crisis. Treatment can include a course of antibiotics, steroids or some form of biological therapy. The treatment and management of crisis should be started as soon as possible, because the condition may progress and affect vision loss and other functions of the eye later in life.
Treatment
There is no treatment for critics, but early intervention may help prevent crisis from worsening. In most cases of iritis, treatment is usually aimed at reducing the pain and inflammation and preventing the crisis from becoming acute. If crisis is severe, a surgical procedure to remove a portion of the rites may be performed. However, in most cases of iritis, the disease is often controlled through a program of nutritional changes, antibiotic treatment and stretching exercises meant to correct any deformities that may be causing pressure on the iris.
In most cases of iritis, the iridocyclitis is mild and will not require treatment. A catheter inserted through a tiny incision into the eyelid and into the choroid can drain the fluid that has built up there. However, in cases of iridocyclitis, the fluid can build up in the choroid and prevent drainage. Cysts may also form in other areas of the eye such as the iris, the peripheral retinopathy or the retinal detachment. These can be very serious conditions and need to be diagnosed and treated promptly.
The treatment of iridocyclitis and of anterior uveitis depends on their respective conditions. For example, if the patient is suffering from iritis, corticosteroids, antibiotics, and anti-inflammatory drugs can help alleviate symptoms. In some cases, surgery is needed to remove the iris and ciliary body. However, patients with severe iridocyclitis require surgery because it cannot be treated using conventional medications.
The treatment for both conditions usually lasts for six weeks. If the patient is suffering from iritis, physical therapy and stretching are needed. On the other hand, if the patient has anterior uveitis, corticosteroids and antibiotics are given. Thus, it is important to properly diagnose iris and anterior uveitis to properly treat them.