Medicines for Iritis

What it is

Iritis (also called anterior uveitis) is inflammation of the iris — the coloured part of the eye — and the area just behind it. It is a common form of uveitis (inflammation inside the eye). It typically causes a painful, red eye (with the redness often most marked around the coloured part of the eye), sensitivity to light (which can be quite marked, making bright light uncomfortable), blurred vision, a small or irregular pupil, and sometimes watering and an aching pain. It usually affects one eye but can affect both, and can come on over hours to days. The cause is often not identified (and it may occur on its own), but iritis can also be associated with certain underlying conditions — particularly some autoimmune and inflammatory conditions (such as ankylosing spondylitis and some others), and occasionally infections — so recurrent or bilateral iritis may prompt a search for an underlying cause. Iritis is important to treat promptly, because, although it is usually very treatable, if left untreated the inflammation can lead to complications affecting the eye (such as raised eye pressure, cataract, or sticking of the pupil). With prompt treatment, most people recover well. Because a painful red eye can have other causes, some serious, it should be assessed by an eye professional.

How it is treated

Iritis is diagnosed and managed by an eye professional (optometrist or ophthalmologist), who examines the eye (often with a specialised microscope) to confirm the inflammation and check for complications, and to distinguish it from other causes of a red, painful eye. Treatment aims to reduce the inflammation, relieve the pain and light sensitivity, and prevent complications, and is usually effective. The mainstays are: steroid eye drops to settle the inflammation (used frequently at first, then reduced gradually as the inflammation improves, under guidance); and eye drops that dilate the pupil, which relieve the aching pain (by relaxing the eye muscles) and help prevent the pupil sticking. Most cases settle over a few weeks with treatment, though it is important to follow the treatment schedule and attend follow-up to ensure it resolves and to monitor for complications. Iritis can recur, and people with recurrent episodes learn to seek treatment promptly. Where iritis is recurrent, affects both eyes, or occurs with symptoms elsewhere (such as back or joint problems, or bowel symptoms), assessment for an underlying condition may be arranged, and any identified condition managed. The reassuring message is that iritis is usually very treatable with steroid and dilating eye drops, and that prompt treatment relieves the symptoms and prevents complications — so a painful, light-sensitive red eye should be assessed promptly.