Iridocyclitis

Iridocyclitis General Information

Iridocyclitis is an iris inflammation (an inflammation localized in the colored part of the eye). It may also extend to the ciliary body (the muscles and tissue that are involved in focusing and moving the eye). This condition is also known under the names of anterior uveitis and iritis. Generally, it is caused by direct exposure to chemicals that cause an inflammatory reaction in the eye – generic lachrymators, but there are other compounds with similar effects. It can also be caused by viral infections localized in the eye region, and in such cases we are dealing with the herpetic form of this medical condition such as the one caused by herpes zoster.

This affection may be classified in six subtypes. The acute type presents a sudden outburst of the symptoms, and it can last as long as six weeks, while the chronic form can be asymptomatic but lasts for an extended timeframe, longer than 6 weeks. The chronic version of the affection is typically associated with other underlining disorders such as tuberculosis, syphilis, Reiter's syndrome, Lyme disease, sarcoidosis, Behçet's syndrome, ankylosing spondylitis or inflammatory bowel disease.

Another classification of this condition (Iridocyclitis) can be done by taking into account the source of the damage to the iris – if the damage is from an external source, the affection is exogenous, while if it is caused by internal bacteria and viruses it is endogenous. Also, in cases where the affection presents large keratotic precipitates, it is known as the granulomatous type, while small keratotic precipitates accompany the non-granulomatous version of the affection.

Iridocyclitis Symptoms

Patients afflicted with Iridocyclitis experience photophobia as the most common symptom, which is basically an excessive sensitivity to light characterized by eye discomfort or pain caused by exposure to natural or artificial light. Another symptom often encountered in such cases is miosis, or constriction of the pupil. Redness, watery eyes and excessive lacrimation, as well as blurred vision may all accompany cases of iritis. Synechia has also been reported as a symptom in patients affected by this condition.

The acute version of this affection consists of an abrupt outburst of symptoms. Most often, the patients have a genetic predisposition to suffer from acute Iridocyclitis, case in which other family members may have suffered from it as well. This genetic predisposition also exposes the patient to psoriasis, inflammatory bowel disease and lower back arthritis.

The chronic type is often asymptomatic, but it can cause severe eye damage over time. The damage is especially dangerous in children, where it may be aggravated by a number of related conditions, such as juvenile rheumatoid arthritis. In such cases, the risks are extreme, as the affection may cause permanent blindness. It is highly advised that children that suffer from such related affections are also tested periodically by a specialized eye doctor, in order to detect any signs of Iridocyclitis. Since this condition may develop years after the patient has been treated for juvenile rheumatoid arthritis, it is advised that the patients undergo regular eye testing.

Iridocyclitis Treatment

If you find yourself experiencing any of the Iridocyclitis symptoms that we have listed above or any other signs that are specific for this particular medical condition it is highly advised that you immediately set an appointment with your personal physician and go through a full medical check up as soon as possible. In this way, you will enable your personal health care provider set a proper diagnosis of your medical condition. Like in most other medical disorders, early diagnosis of this disease is always an advantage, as early therapy for this clinical condition ensures better results.

The common treatment applied in diagnosed cases of Iridocyclitis is based on tropane alkaloids or steroids. Tropane alkaloids serve to immobilize the iris and also to decrease pain. Examples of such drugs would be atropine (in concentrations of 1%) or scopolamine (a concentration of 0.25% would be recommended). Topical steroids, such as prednisolone or dexamethasone, are particularly useful in decreasing the inflammation and preventing structural eye damage. They are available under several forms, such as pills, eye drops, ointments or injections specifically designed to be administered in the area surrounding the eye. Severe cases may be met with administering a steroid based medicine through subconjunctival injection. However, it should be noted that a treatment based on corticosteroids may result in the appearance of side effects, such as glaucoma, cataracts or a decreased resistance to fungal, viral or bacterial infections. It is highly advised that the specialized health care professional monitors the patient undergoing such a treatment to discover any side effects that may appear.
In the case of children also affected by juvenile rheumatoid arthritis, Iridocyclitis treatment should start with steroid drug therapy, either topical or under the form of local injections. In some cases, systemic steroids may be the best option for treatment. Some of the patients may experience a recurrence of the condition every time the steroid treatment is ceased. If this is the situation, the next step in treating the condition should be administering an oral non-steroidal anti-inflammatory drug, such as Naprosyn or Tolectin. The dosage and intake schedule may vary largely from one patient to another, so it is highly advised that you follow the exact indications that your personal health care specialist has provided. Also, it is strongly recommended that you do not modify the dosage in any way, either by altering the dose or changing the intake schedule, as severe side effects may appear.

If the patient’s state does not improve and the Iridocyclitis still continues to recur every time after the steroid treatment is ceased, the recommended solution is changing the therapy to a low dose of methotrexate to be taken once per week. So far, this type of treatment has proven to yield great results, as well as very low risks. There are some very rare cases of Iridocyclitis where methotrexate therapy may not be suited for a particular patient, or where this drug may not achieve the desired effects. In such cases, the health care specialist may prescribe a different immunomodulator agent with similar effects to replicate the results expected from methotrexate treatment.