Introduction
Iridocyclitis is inflammation of the vascular membrane of the eye. It affects the iris and the eye's ciliary body. The rash begins in the vascular membrane of the eye. The inflammation then spreads very quickly to the other parts of the eye. Iridocyclitis can be diagnosed at any age but is more common in patients from 20 to 40 years old. The disease can be acute or chronic, depending upon the duration. Inflammatory changes can be severe, exudative, fibrinous-plastic, and hemorrhagic. Depending upon etiology, it can be infectious, infectious-allergic, allergic non-infectious, post-traumatic, or unclear etiology. Acute iridocyclitis usually lasts up to six weeks but can extend for several months. The relapse of the disease more commonly occurs in the cold season.
What Are the Causes of Idridocyclitis?
The function of the uveal layer of the eye is to exchange gasses and give nutrients to another part of the eye. The iris and the ciliary body are also involved in eye movement control and the production of fluid in the eye. Several factors can disturb these normal functions of the eye and can result in iridocyclitis. The causes that can trigger the abnormal response in the iris and the ciliary body, which leads to iridocyclitis, are given below:
1. Problems With the Immune System: People with weak immune systems are more prone to develop iridocyclitis. Some autoimmune disorders can cause the disease. Faulty autoimmune response of the body, where the body's immune system starts to attack healthy tissues. These include multiple sclerosis (disorder affects nerve covering), reactive arthritis (autoimmune disorder affects muscle tissue), Bechet's disease, and sarcoidosis.
2. Infections: Some bacteria, parasites, and viruses can enter the eyes through the ciliary body or the iris. Herpes zoster virus can cause herpetic iridocyclitis. It can cause permanent damage. It can also be due to systemic infections such as tuberculosis, toxoplasmosis, HIV, and syphilis.
3. Physical Injury: A direct injury to the eyes can also lead to iridocyclitis.
4. Side Effects of Drug Usage: Iridocyclitis can also be due to the side effects of some drugs. The drugs that can cause iridocyclitis are Rifampicin and quinolones.
5. Exposure to Chemicals: Some chemical exposure can cause iridocyclitis, such as lachrymators or the chemical used in tear gas for controlling crowds.
6. Other Conditions: Sometimes, iridocyclitis occurs due to other underlying conditions of the body. It includes juvenile rheumatoid arthritis. It causes swelling of the eyes and is commonly seen in females. Lymphoma is a type of cancer also known to cause iridocyclitis.
What Are the Symptoms of Iridocyclitis?
The degree of severity and symptoms of iridocyclitis depend on the cause, nature, and duration of the agent causing the disease. The immune status of the individual is essential.
-
The first symptom of acute iridocyclitis is redness and pain in the eye. Patients with iridocyclitis usually show photophobia (increased sensitivity to light) and lacrimation. Visual acuity shows a slight decrease from the average. A cloudy appearance in front of the eyes is a common symptom among all patients. In iridocyclitis, a change in the color of the inflamed iris is seen. In iridocyclitis on the posterior surface of the cornea, a grayish-white precipitate is seen.
-
Swelling of the iris tissues is commonly observed. The presence of exudate leads to the formation of posterior adhesions (synechiae), irreversible constriction of eye tissue (myosis), and deformation of the pupil. Synechiae can cause blindness because of overgrowth of the pupil. Fall intraocular pressure in iridocyclitis is seen. Sometimes, exudation is seen in the acute onset of iridocyclitis, leading to an increase in intraocular pressure.
-
Different types of iridocyclitis have additional clinical features. Viral iridocyclitis leads to the formation of serous or serous-fibrinous exudate with increased intraocular pressure of the eye. Tuberculous iridocyclitis starts with mild symptoms, and then large sebaceous precipitates are seen on the iris. Finally, vision becomes blurred, and overgrowth on the pupil is seen. In autoimmune iridocyclitis, a severe recurrent course of the disease is seen. Every relapse is more potent than the previous one. The condition often leads to blindness. In traumatic iridocyclitis, inflammation of an eye may be seen.
How Is Iridocyclitis Diagnosed?
A visit to the doctor is a must in cases of eyes being red and eye pain with sensitivity to light.
A thorough history and proper examination are essential for an appropriate diagnosis of the condition. In addition, various blood examinations and vision tests are necessary to make a correct diagnosis.
Iridocyclitis is classified as follows:
-
Acute Iridocyclitis: The onset is sudden; the usual duration is three weeks but can last up to six weeks.
-
Chronic Iridocyclitis: Persistent inflammation is seen, and the time of condition lasts for more than three months.
-
Recurrent Iridocyclitis: The disease relapses frequently.
How to Treat Iridocyclitis?
An eye doctor treats iridocyclitis to reduce inflammation, give relief to eye pain, and prevent complications that can cause blindness. Iridocyclitis treatment may include eye drops which help dilate the pupil, reduce spasms, and lower the eye's inflammation. Drugs used in the treatment of iridocyclitis are:
-
Anticholinergics - These help in the treatment of sensitivity to light and reduce eye pain.
-
Topical Steroids - These are used to decrease inflammation in the eye.
Patients who have iridocyclitis due to underlying other health conditions require additional treatment. For example:
-
A patient with a bacterial infection also requires antibiotics to treat the underlying condition.
-
Patients with arthritis or inflammatory bowel disease require drugs such as tumor necrosis factor blockers (Adalimumab or Infliximab) to prevent vision loss.
Regular eye examinations are required every few days. Monitoring is essential for patients to prevent further vision loss. In addition, a sudden pressure change can harm a person's vision, so a follow-up every one to six months after initial treatment is also necessary.
What Is the Prognosis of Iridocyclitis?
Iridocyclitis is associated with a favorable prognosis. If proper treatment, observation, and cure are given, a complete recovery is possible without complications. However, there are high chances of relapse even after complete healing. If treatment is not provided correctly, it can lead to an inferior prognosis.
Conclusion
Iridocyclitis is an abnormal eye condition affecting the iris and ciliary body. Although it is not a fatal condition, it causes a lot of pain and discomfort to patients when it occurs. Proper diagnosis on time and appropriate treatment must stop further damage to the eye. Therefore, it is recommended to get the treatment as early as possible. It is common for iridocyclitis to be mistaken for other eye diseases, such as glaucoma or conjunctivitis.
