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Iritis is inflammation of the colored part of the eye, called the iris, and nearby tissues. Iritis (i-RYE-tis) is the most common type of a condition called uveitis (u-vee-I-tis).

Iritis symptoms often come on suddenly and get worse quickly. The condition can affect one or both eyes. It can affect people of all ages, even children.

Possible causes of iritis include infection, injury or immune system conditions. Often, the cause of iritis is not known. Early diagnosis and treatment are important to prevent vision loss.

Symptoms of iritis often come on suddenly. These may include:

• Eye pain.
• Pain that worsens with bright light or reading.
• Sensitivity to light.
• Decreased vision.
• Eye redness.
• Watery discharge.

Sometimes people feel discomfort or achiness in the affected eye before other symptoms appear.

Sometimes people have very mild symptoms or no symptoms. This happens most often when the condition develops gradually over a long time. This is called chronic iritis.

When to see a doctor

Contact your healthcare team if you think you have symptoms of iritis. You may be referred to an eye specialist, called an ophthalmologist. If you're having severe eye pain and sudden vision problems, get emergency care.

Iritis is the most common type of uveitis. Uveitis is a general term for inflammation of the layer of the eye called the uvea (U-vee-uh).

Inflammation is typically the immune system's reaction to disease or injury. An inflammatory reaction increases blood flow, releases proteins that help defend cells and delivers disease-fighting cells.

Inflammation is usually a part of a healing process. But long-term inflammation from untreated disease or injury can damage tissues. Inflammation also can happen when the immune system attacks healthy tissues. This is called an autoimmune disease. All of these factors are possible causes of uveitis.

Uveitis is inflammation in part or all of the uvea. The uvea is the layer of tissue between the white outer part of the eye, called the sclera, and the inner layer of light-sensitive tissue called the retina. The uvea has three parts:

• Iris.
• Ciliary body.
• Choroid.

In iritis, inflammation is mostly in the iris and the front of the ciliary body.

In many cases, the cause of the inflammation cannot be found. There are a number of conditions that can cause iritis.

• Injury to the eye from trauma or surgery can cause inflammation.
• Infections that most often cause iritis include:
  • Herpes.
  • Chicken pox and shingles.
  • Syphilis.
  • Lyme disease.
• Bacterial infection after surgery on the eye may cause inflammation.
• Juvenile rheumatoid arthritis is an autoimmune disease that's the most common cause of iritis in children.
• Autoimmune diseases linked to a particular gene may cause iritis. These include diseases of the bones and joints called ankylosing spondylitis and reactive arthritis.
• Sarcoidosis is an autoimmune disease that can cause inflammation throughout the body, including in the eyes.

Infections and autoimmune diseases related to iritis do not always result in the inflammation of the iris, but the chance of developing iritis increases with these diseases.

Smoking may increase the risk of iritis and increase the risk of more-severe disease.

If not treated, iritis can lead to:

• Cataracts. A cataract is clouding of the lens of the eye. Cataracts can be a complication of iritis or corticosteroid treatment for inflammation.
• Glaucoma. Glaucoma is a type of damage to the optic nerve. This condition can be a complication of iritis or corticosteroid treatment for inflammation.
• An irregular pupil. The inflamed iris can stick to the clear outer covering of the eye, called the cornea. Or it may stick to the capsule holding the eye's lens. This can cause the pupil to lose its typical shape and not adjust to light.
• Calcium deposits on the cornea. Calcium can be deposited on the cornea in a condition called band keratopathy. This complication causes clouding of the corneal tissue and can decrease vision.

A doctor specializing in eye care, called an ophthalmologist, will likely do a complete eye exam and gather a thorough health history. The eye exam usually involves the following:

• Vision test. A vision test, also called a visual acuity test, uses eye charts to measure how well you can read a series of letters. One eye is tested at a time, while the other eye is covered.
• Microscopic exam. Your eye doctor may use a specialized microscope to look at the outer eye and structures inside the eye. This exam is often done with a device called a slit lamp. It uses bright light and a microscope to see precise details of structures or irregular changes in your eye. With this exam, you may have eye drops to enlarge your pupils.
• Intraocular pressure test. This test measures the pressure inside your eye. There are multiple devices available to do this.

Your eye doctor may order other tests to rule out other types of uveitis or other eye conditions. These include:

• Color photography. of the inside of the eye.
• Optical coherence tomography (OCT) imaging. These images map the retina and choroid to reveal inflammation in these layers.
• Fluorescein angiography or indocyanine green angiography. These tests require placement of an intravenous tube, also called an IV, in a vein in your arm. The IV delivers a dye that goes to the blood vessels in the eyes. The dye allows for detailed photographs of inflamed blood vessels inside the eyes.
• Analysis of fluids from the eye.

Your eye doctor or primary healthcare professional will likely order tests to find possible causes of iritis. Tests may include:

• Blood tests to look for possible infections.
• Genetic tests to look for links to possible autoimmune diseases.
• X-rays to look for signs of diseases that may cause iritis.

The treatment goals for iritis are to reduce inflammation, lessen symptoms, and prevent vision loss or other complications.

Most often, treatment for iritis involves:

• Steroid eyedrops. Corticosteroid medicines, given as eyedrops, are the primary treatment for reducing inflammation and lessening symptoms.
• Dilating eyedrops. Eyedrops that make your pupils larger for a while can lessen pain. The medicine also can prevent the pupil from sticking to the cornea or lens capsule.

If your symptoms don't clear up or if they worsen, your eye doctor may prescribe corticosteroid pills or other anti-inflammatory medicine. Your eye doctor may prescribe other medicines or refer you to other specialists to treat underlying diseases.

Your eye doctor may recommend follow-up care and monitoring.

Your symptoms may prompt you to make an appointment with your primary healthcare team. You may be referred to a doctor who specializes in diseases of the eyes, called an ophthalmologist.

Here's some information to help you get ready for your appointment and know what to expect from your eye doctor.

What you can do

Make a list of:

• Your symptoms, including any that may seem unrelated to your eyes.
• All medicines, vitamins or supplements you take, as well as the doses and the reason for taking each one.
• Key personal information, including recent trauma or injury and your family medical history, including whether any family member has an autoimmune disease.
• Questions to ask your eye doctor.

Take a family member or friend to your appointment, if possible, to help you remember information you're given. Also, having your pupils dilated for the eye exam affects your vision for a time afterward, so it might be helpful to have someone drive you home.

For eye symptoms, some questions to ask your eye doctor include:

• What is likely causing my symptoms?
• What tests will you order?
• What should I do if my symptoms don't go away or seem to worsen?
• I have other health conditions. How can I best manage them together?
• Do I need to come back for follow-up exams? When?
• Do you have brochures or other printed material I can have? What websites do you recommend?

What to expect from your eye doctor

Your eye doctor is likely to ask you several questions, such as:

• Do you have symptoms in one or both eyes?
• When did your symptoms begin?
• How would you rate the pain on a scale of 1 to 10?
• Have you noticed a change in your vision?
• Are you sensitive to light?
• Does bright light or reading worsen your eye pain?
• Do you have symptoms of arthritis, such as joint pain?
• Do you have sores in your mouth or on your genitals?
• Are you taking medicine to treat an infection?
• Have you had iritis before?
• Have you been treated for other eye conditions?