Definition

Iritis is an inflammation of the iris, which is the colored circle that surrounds the pupil (the black circle in the middle of the eye). The iris is the part that gives color to the eyes because it contains pigments. In addition to serving to give color, the iris also serves to control the amount of light that enters through the pupil through the work of the muscle fibers it has. This is what makes the pupil will shrink when the light is bright and widen in dim light. The cause of iritis is often unknown, but genetic factors have been shown to play a role in the emergence of iritis.

Cause

Often, the cause of iritis is unknown. In some cases, iritis is related to eye injury, genetic factors, or certain diseases, especially autoimmune diseases. Causes of iritis include:

• Eye injury. Blunt trauma, sharp trauma, and chemical or thermal burns can cause acute (new) iritis.
• Infection. Viral infections on the face can also cause iritis. Bacterial infections in other parts of the body are also associated with iritis, such as tuberculosis (bacterial infection Mycobacterium tuberculosis), syphilis (a sexually transmitted infection by the bacterium Treponema pallidum), or toxoplasmosis (a parasitic infection Toxoplasma gondii).
• Genetic factors. People with certain autoimmune diseases (diseases that attack the immune system) due to gene mutations, can experience acute iritis. Autoimmune diseases include psoriatic arthritis (arthritis), ankylosing spondylitis (arthritis of the spine), and inflammatory bowel disease (inflammation of the intestine).
• Behcet's disease. This disease is a rare cause of acute iritis, this condition is characterized by joint problems, mouth ulcers, and wounds in the genital area.
• Juvenile rheumatoid arthritis (rheumatism in adolescents). Chronic iritis can develop in children with this condition.
• Sarcoidosis, which is inflammation affecting various parts of the body, such as the lungs, lymph nodes, eyes, and skin. This autoimmune disease can cause the appearance of inflammatory cell clusters in body areas, including the eyes. 
• Kawasaki disease, which is inflammation of the blood vessel wall.
• Ulcerative colitis, which is inflammation of the large intestine.
• Certain medications. Some medications, such as the antibiotic Rifabutin and the antiviral drug Cidofovir used to treat HIV infection can be a rare cause of iritis. Bisphosphonates, which are osteoporosis drugs, can also cause iritis. By stopping the use of these drugs, it will stop the symptoms of iritis that arise.

Risk Factors

Your risk of getting iritis increases if you:

• Having certain gene mutations. People with mutations in genes that play an important role in the immune system are more likely to have iritis.
• Having a sexually transmitted infection. Certain infections such as syphilis or HIV/AIDS are associated with an increased risk of iritis.
• Having a weak immune system or disorders in the immune system. This includes ankylosing spondylitis and arthritis
• Smoking. Research proves that cigarettes can increase your risk of experiencing iritis.

Symptoms

Iritis can occur in one or both eyes. It usually appears suddenly and can last up to three months. Signs and symptoms of iritis include: 

• Red eyes
• Pain or discomfort in the eyes
• Headache, especially around the eyes
• Sensitive to light
• The pupil is irregular.
• Vision loss if it is chronic (long-lasting)

Iritis that has just appeared in a few days, is called acute iritis. While those who stay more than three months are called chronic iritis.

Diagnosis

To diagnose iritis, the ophthalmologist will conduct an interview and a complete eye examination. The interview contains questions about the signs and symptoms felt and other disease history. After that, the doctor will perform several eye examinations as follows:

• External examination. The doctor performs an examination using a flashlight to see the pupils, observe the pattern of redness in the eyes, and check if there is excess eye fluid or dirt.
• Examination of visual acuity. The doctor will test your visual acuity using special charts and other standard tests.
• Examination slit lamp. The doctor will look inside your eye and look for signs of iritis using a special microscope. By dilating your pupils using special eye drops, the doctor can see the inside of your eye better

If an ophthalmologist suspects that there is a disease or condition that causes iritis, the doctor will work with other specialists to determine the cause of your iritis. In this case, further examinations such as blood tests or X-ray photos may be needed to find or rule out the cause of iritis.

Procedure

Treatment of iritis aims to preserve vision as well as relieve pain and inflammation. For iritis associated with other diseases, treating the disease will help healing.

Medications commonly prescribed by ophthalmologists include anti-inflammatory eye drops and pupil dilators to reduce pain. Pupil dilators also protect the eyes from complications that can interfere with pupil function. If symptoms do not subside or seem to worsen, the doctor can prescribe appropriate oral medications for your condition. If the eye condition is serious or complications arise, surgery may be another option in treatment.

After getting treatment from an ophthalmologist, here are some steps you can take for home treatment:

• Follow the rules for using drugs according to doctor's instructions
• Wear dark glasses if the light makes your eyes hurt.
• You can take pain medication if needed.

If iritis is caused by eye injury, it will generally heal within 1-2 weeks. In other cases, it may take weeks to months to heal. 

Complications

If not treated properly, iritis can cause the following complications:

• Cataracts, that is, clouding of the lens of the eye. This complication may occur, especially if inflammation occurs for a long time.
• The shape of the pupil is irregular. The scar tissue that appears due to inflammation can cause the iris to stick to the lens or cornea, making the shape of the pupil irregular and the iris slow in reacting to light.
• Glaucoma, namely increased eye pressure and nerve damage. This complication can cause vision loss.
• Calcium accumulation in the cornea (band keratopathy). This causes damage to the cornea and can reduce vision.
• Swelling of the retina (the back layer of the eye that captures light). This swelling can reduce your central vision area.

Prevention

Prevention of iritis is difficult to do because most iritis are unknown causes. However, early detection and immediate treatment can reduce the risk of permanent vision loss. In addition, treating other underlying diseases, such as autoimmune diseases, can prevent the onset of iritis.

When should you see a doctor?

Consult an ophthalmologist as soon as possible if you have symptoms of iritis. Immediate treatment can help prevent serious complications. If you have eye pain and vision impairment with other signs and symptoms, you may need immediate medical treatment. The likelihood of recurrence in iritis is quite large. Therefore, if you experience complaints similar to symptoms when you were exposed to iritis previously, immediately consult a doctor.

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