Iritis, eye inflammation / Red eye, light sensitive - A State of Sight #104

Iritis can cause eye pain, light sensitivity, and redness from inflammation inside the eye. Fortunately, treatments are available to improve comfort and vision when this occurs.

Watch this episode of A State of Sight with Isaac Porter, MD to learn more about iritis including possible causes and treatment options.

Welcome to A State of Sight, I’m Isaac Porter and this is your update in ophthalmology and eye care from Raleigh. In this episode, I would like to explain iritis, which is inflammation inside the eye.
This can happen very commonly. One thing patients may notice at first is redness of the eye. They may have some pain, like aching in the eye. A lot of times it could be one eye but it could be both. They may also notice they are sensitive to light and their vision becomes blurry.

When it’s the first episode of iritis, a lot of people aren’t sure what’s going on, but once they have repeat episode, they usually know they are having a flare of iritis. When they come in for an examination, we can see signs of iritis by looking with the microscope. Particularly, we will see inflammation inside the eye, which can be cells we see inside the anterior chamber, the front part of the eye just behind the cornea. We may also see spots we call KP, or keratic precipitates, which are clumps of inflammation inside the cornea.

Other things we may see are a small pupil or there may be scarring or adhesions from the pupil to the lens behind the iris or to the cornea in front. It is possible for iritis to resolve on its own, but that may take a period of time, maybe four to six weeks. If the iritis comes out of the blue for no particular reason, it is possible to observe the inflammation, but most of the time we like to treat it to make the patents feel better and see better as soon as possible.  

Usually this is done with steroid eye drops and, in the beginning, we may use them very frequently to help bring down the inflammation. Then the drops can be tapered or stopped once the inflammation is resolved. Other times, we may use dilating drops to help keep the pupil wide and to make our patients more comfortable and to help decrease the inflammation as well.

Often, we don’t know why someone has iritis. If the irits is mild and the first episode, we may not perform further investigation looking for the cause, if the patient has no other systemic clues as to why they may be having iritis. If it’s more severe, or if it comes back one or multiple times, we like to check to see if there is a problem throughout the body that maybe causing iritis.

This could be from inflammation from diseases like rheumatoid arthritis or multiple sclerosis. Also infections from a virus like the herpes virus can cause iritis. Many times, we don’t know why it happens and we just have to treat the symptoms and inflammation.

If you have any questions about iritis or if you’ve had it in the past and wonder about the long term problems or treatment options, please post and we will be happy to answer them. We hope to see you again next time on A State of Sight.