Inflammation of the iris (iritis)

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In iritis, the colored part of the eye around the pupil is inflamed - the iris or iris. It is one of three layers of the middle skin of the eye (uvea). Thus, iritis is a sub-form of uveitis (= inflammation of the middle skin of the eye). How to recognize iris inflammation, what causes it and why it should definitely be treated, read here!

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. H20

Brief overview

• What is iritis A mostly acute, less often chronic inflammation of the iris of the eye. At the same time, the ciliary body is usually inflamed, which is known as iridocyclitis.
• Symptoms: reddened, light-sensitive eyes, visual disturbances such as veils and flakes in front of the eyes, eye pain, headache
• How long does iritis last? Acute iritis heals under therapy after two to six weeks. Chronic iris inflammation lasts longer than three months and requires repeated treatment.
• Possible consequences of iritis: e.g. adhesions of the iris with neighboring structures, cataracts (cataracts), glaucoma (green star)
• Causes: usually no recognizable cause. In other cases, it is related to a certain genetic trait (HLA-B27) or inflammatory or rheumatic diseases (such as rheumatoid arthritis, Crohn's disease, sarcoid, etc.) or certain infections (such as borreliosis).
• Diagnosis: eye examination using a slit lamp, examinations to determine the cause such as imaging procedures or blood tests
• Treatment: cortisone (mostly as eye drops or ointment, possibly cortisone tablets), pupil-dilating eye drops, if necessary treatment of the underlying disease (e.g. with antibiotics or rheumatism drugs).

Irritation of the iris: symptoms

Depending on whether the iris inflammation occurs acutely or develops insidiously, different symptoms occur.

Symptoms of acute iritis

• Headache, eye pain
• reddened eyes
• photosensitive eyes
• Visual disturbances (e.g. blurred or flaky vision)

Symptoms of insidious iritis

A slowly developing iris inflammation is usually symptom-free at first. Only over time do visual disturbances or reduced eyesight develop. This is why this form of iris inflammation is often recognized and treated late.

Irritation of the iris: causes

Most of the time, iris inflammation cannot be traced back to any identifiable cause. Then one speaks of idiopathic iritis.

Genetic trait HLA-B27

Many other patients with irisitis (or any other form of anterior uveitis) have a specific genetic trait - HLA-B27. This is a specific protein that is found on the surface of almost all cells in these patients. People are more prone to anterior uveitis, such as iris inflammation.

Inflammatory or rheumatic diseases

People with HLA-B27 not only have an increased risk of anterior uveitis (such as iritis), but also of some other inflammatory or rheumatic diseases such as:

• inflammatory bowel disease (Crohn's disease, ulcerative colitis)
• Rheumatoid arthritis
• reactive arthritis (Reiter's disease)
• Psoriatic arthritis
• ankylosing spondylitis
• Ankylosing spondylitis (Bechterew's disease)

Irritation of the iris can also occur as part of these diseases. Often, iritis is one of the first symptoms of such diseases.

HLA-B27 cannot be detected in all patients with one of these inflammatory or rheumatic diseases. Nevertheless, iris inflammation can also occur in such cases.

Another systemic inflammatory disease in the context of which iritis can develop is sarcoid. This autoimmune inflammatory disease is associated with the formation of nodular tissue changes that mostly affect the lungs. But inflammatory processes can also be set in motion in other parts of the body, for example in the iris.

Infections

In the context of some infections that affect the whole body or an entire organ system, the iris can become inflamed. This can happen with borreliosis, tuberculosis, chlamydia infection, flu (influenza) or herpes virus infection.

Iris inflammation: is it contagious?

Iritis is not considered to be contagious. However, if it occurs as part of certain infectious diseases (such as tuberculosis or chlamydial infection), it can be passed on to other people - tuberculosis, for example, through droplet infection, and chlamydial infection, among other things, through sexual intercourse.

Eye injuries

Sometimes iris inflammation develops as a result of blunt eye trauma (such as a blow to the eye) or chemical burns to the eye. Then doctors speak of traumatic iritis or chemical iritis.

Iris inflammation: diagnosis

The ophthalmologist will first collect your medical history (anamnesis) in conversation with you. He asks you, among other things, which symptoms you have exactly, whether you have ever had an inflammation in the eye area and whether you are known to have any underlying diseases.

This is followed by a slit lamp examination. With this microscopic examination of the anterior segment of the eye, the doctor can detect typical changes in the case of iris inflammation, for example a narrowing of the pupil or adhesions or adhesions of the iris with the lens or cornea.

If there is suspicion that inflammation-related adhesions in the eye are obstructing the outflow of aqueous humor and thus causing the pressure in the eye to rise so much that there is a risk of glaucoma, the intraocular pressure is measured (tonometry).

Further examinations are helpful to clarify possible causes of iritis (or iridocyclitis). For example, joint changes caused by rheumatism can be made visible with the help of imaging processes (such as x-rays). If there is a suspicion of an infection in the body that has spread to the iris in the course of time, blood tests can bring clarity.

To clarify possible underlying diseases that cause iritis or iridocyclitis, the ophthalmologist will consult other specialists, for example an internist or rheumatologist.

Irritation of the iris: treatment

Irritation of the iris is primarily treated with eye drops or ointments containing cortisone. They have an anti-inflammatory effect. In addition, the ophthalmologist often prescribes eye drops to dilate the pupil. They prevent adhesions between the inflamed iris and the lens. If necessary, anti-inflammatory painkillers from the NSAID group are also used.

Usually these measures are sufficient to cure acute iritis. In more severe cases, internal corticosteroid therapy may also be necessary, for example taking corticosteroid tablets.

If the iris inflammation is related to an underlying disease, it is important to treat this properly as well. If the iritis (or iridocyclitis) is due to a bacterial infection, for example, the doctor will prescribe antibotic therapy (e.g. antibiotic eye drops or antibiotic tablets). Antiviral agents (antivirals) are available to treat some viral infections. A rheumatic disease usually requires long-term, comprehensive treatment, including various rheumatic drugs.

Irritation of the iris: course and prognosis

If the acute iritis is recognized and treated quickly, the chances of recovery are very good. As a rule, it heals after two to six weeks without any consequential damage.

In the case of underlying rheumatic diseases in particular, acute iritis can recur (recurrent iritis) or persist chronically (chronic iritis). The duration of inflammation in the second case extends for at least three months. In such cases, iris inflammation must be treated repeatedly. Some experts recommend long-term treatment with long-term anti-inflammatory drugs, analogous to the medical recommendations for the treatment of chronic inflammatory rheumatic diseases. However, the effectiveness of this treatment is only based on empirical values ​​- it has not been well researched and has not been scientifically recognized.

With chronic recurrent inflammation, there is an increased risk of complications.

Irritation of the iris: complications

If iritis is not treated quickly and correctly, there is a risk of permanent damage and secondary diseases in the affected eye, such as:

• Connective tissue adhesions or adhesions (synechiae) of the iris with the cornea or lens
• Cataract
• Glaucoma

Rarely, iris inflammation can also result in atrophy of the iris.

Background: iritis as a form of uveitis

The inflammation of the iris (iritis) is a form of anterior uveitis. This is an inflammation of the front area of ​​the middle skin of the eye (uvea). Another form of anterior uveitis is inflammation of the ciliary body (cyclitis). This rarely occurs alone, but mostly in connection with an inflammation of the iris (iritis). In summary, doctors speak of iridocyclitis.

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