A new patient visited my office recently complaining of a red and irritated eye for the past two weeks. He also reported being light sensitive. He was prescribed two different antibiotics by his general practitioner, which is commonly used to treat red eye caused by bacterial infections. Unfortunately the medication did not relieve his symptoms as he was suffering from a condition known as iritis and not a bacterial infection.
Iritis is a common inflammation of the eye, more specifically the iris. The iris is the coloured part of the eye. In iritis, the iris becomes inflamed and the blood vessels within the iris leak white blood cells and protein into the anterior chamber (the cavity in the front of the eye). The ciliary body which is behind the iris may also become inflamed with iritis. Iritis is not an infection and it is not contagious. The symptoms of iritis include light sensitivity, throbbing eye pain, and blurred vision. The eye will look very red and inflamed and some patients need to wear sunglasses to help with the light sensitivity.
Iritis is treated by using two different eye drops. One drop serves to dilate the pupil to help reduce the eye pain. The second drop is a steroid to calm the inflammation. Depending on the severity of the iritis, the drops may be used for up to four weeks. The steroid drops used for treating iritis need to be used according to the schedule recommended by your eye doctor since there can be complications from using steroids for a prolonged period of time. A patient suffering from iritis is slowly tapered off the steroid drop to reduce the chance of a rebound effect or reoccurrence of the iritis. The commonly prescribed antibiotics for red eye are useless in treating iritis.
What causes iritis? In most cases we don’t know what causes it. For some patients, iritis can occur regularly. Blood tests or x rays can be done to find a potential cause. The following conditions contribute to the cause of iritis including rheumatoid arthritis, juvenile rheumatoid arthritis, anklylosing spondlyitis, lupus, syphilis, gout, herpes virus infection, Chron’s disease, ulcerative colitis, psoriasis, and eye injury.
Most cases of iritis will resolve completely with proper and timely treatment. If left untreated, there is the potential for some permanent vision loss.
The causes of red eye are virtually endless. The treatment required needs to be tailored for the particular cause of red eye. This is evident in the patient I described at the beginning of the article. The two antibiotics he was prescribed were not treating the iritis. This case stresses the importance for patients to seek the care of their optometrist or ophthalmologist to be properly and thoroughly assessed for iritis and other possible causes of red eye.