Iridocyclitis: What is it? Causes and Treatment

October 15, 2021

What is iridocyclitis?

Iridocyclitis is the most common type of uveitis . It appears suddenly, associated with autoimmune diseases , and especially in young and healthy patients.

Most often, iridocyclitis occurs in only one eye , and its symptoms usually last up to two months. The inflammation can be recurrent or chronic, and its prognosis is good, since patients usually have no problems recovering.

Iritis has the characteristic that the iris and the ciliary body become inflamed . These two structures, together with the choroid , form the middle layer of the eye (the uvea). They are found in the front of the eye, and the choroid in the back.

For this reason, iridocyclitis or iritis is also known as anterior uveitis, since it affects the ocular structures located in the anterior part of the eye, and must be differentiated from posterior uveitis , which affects the choroid and structures close to it such as the retina.

Types of iritis

There are different types of iridocyclitis , taking into account different criteria:

According to the cause that originates it

• Exogenous Irodicilitis: It is caused by external causes, for example trauma or germs.
• Endogenous Irodicyclitis: when caused by the body itself.

Depending on the evolution time

• Acute anterior uveitis : symptoms appear suddenly, and disappear within 6 weeks.
• Chronic anterior uveitis : occurs when symptoms last more than 6 weeks, and is usually asymptomatic. It is associated with systemic diseases such as Behcet’s syndrome, ankylosing spondylitis, juvenile rheumatoid arthritis, ulcerative colitis, sarcoidosis, reactive arthritis, syphilis, tuberculosis, and Lyme disease.

By the type of reaction

• Granulomatous iridocyclitis : it is usually due to the direct action of a germ that invades the uvea (syphilis, toxoplasmosis, tuberculosis, etc.).
• Non-granulomatous iridocyclitis : the cause is usually hypersensitivity reactions, and it usually does not respond well to steroid treatment.

Causes of anterior uveitis or iridocyclitis

Iridocyclitis occurs in people who have any of the following conditions:

• Ankylosing spondylitis .
• Crohn’s disease .
• Reiter’s syndrome .
• Juvenile chronic arthritis .
• Rheumatoid arthritis .

However , the causes that cause it are not exactly known, although iridocyclitis is usually related to systemic diseases such as those we have just seen, it can also do so with the following factors:

• Infections (by viruses, bacteria, fungi or parasites).
• Heredity .
• Immune disorders in which antibodies appear .
• The presence of HLA B-27 (genetic marker).

There are many cases in which it is not even possible to suspect the cause that has caused the anterior uveitis.

However, it seems that there is a certain implication of different antibodies that cause inflammation between the iris and the ciliary body, although it is currently not possible to know which antigens or substances ultimately cause their appearance.

Unfortunately, there is currently no known way to prevent anterior uveitis from occurring. The only thing that can be done is to go to the ophthalmological consultation as soon as possible to prevent the inflammation from becoming more serious.

In order for the symptoms of iridocyclitis not to get worse, once they appear it is important to go to the emergency department of the nearest hospital as soon as possible.

Special care must be taken when the symptoms that we talk about in the next section are noticed .

Symptoms of iritis

Patients with anterior uveitis can have a large number of symptoms:

• Severe pain in the eye
• Redness around the iris in the form of sun rays.
• Blurred vision .
• Contraction in the pupil ( miosis ), which cannot react.
• Tearing permanent .
• Cloudy fluid inside the eye , due to the suspension of inflammatory particles (this is known as Tyndall’s phenomenon).
• Whitish deposits in the cornea (inflammatory cells).
• Intense contractions in the eyelids ( blepharospasm ).
• Adhesions between the iris and the lens .
• Bags accumulated under the eye , with abundant inflammatory content (hypopyon).

In addition, complications such as the following may occur in patients with iritis :

• Later appearance of cataract .
• Increased intraocular pressure .
• Swelling of the macula ( macular edema ).
• Retinal detachment.

Treatment of iridocyclitis

We recommend that patients with anterior uveitis not self-medicate in any case. It is very important not to do so, and in your case make an appointment with a specialist in retinal diseases so that he or she determines the treatment to follow.

For the treatment of anterior uveitis, the following solutions are usually used:

• Apply mydriatics to dilate the pupil and avoid discomfort.
• Take corticosteroids to reduce the information.