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Iridocyclitis
Encyclopedia
Iridocyclitis, a type of anterior uveitis
, is a condition in which the uvea
of the eye
is inflamed
.
Iridocyclitis is
Inflammation of the iris and the ciliary body.
(i.e. herpetic iridocyclitis).
Can also be associated with juvenile idiopathic arthritis
(also known as juvenile rheumatoid arthritis). Seen usually with the pauciarticular type in females but polyarticular types are also at risk.
Chronic: Persisting for more than six weeks, possibly asymptomatic. Chronic iridocyclitis is usually associated with systemic disorders including ankylosing spondylitis
, Behçet's syndrome
, inflammatory bowel disease
, juvenile rheumatoid arthritis, Reiter's syndrome, sarcoidosis
, syphilis
, tuberculosis
, and Lyme disease
.
Endogenous: Related to internal microbes
Non-granulomatous: Accompanied by smaller keratic precipitates
s or steroids.
To immobilize the iris
and decrease pain, one may find tropane alkaloids effective, particularly scopolamine
and atropine
in .25% and 1% concentrations respectively. Topical steroids may be used to decrease inflammation, particularly prednisolone
and dexamethasone
. Upon presentation of a severe case, a subconjunctival steroid injection may be administered.
Uveitis
Uveitis specifically refers to inflammation of the middle layer of the eye, termed the "uvea" but in common usage may refer to any inflammatory process involving the interior of the eye....
, is a condition in which the uvea
Uvea
The uvea , also called the uveal layer, uveal coat, uveal tract, or vascular tunic, is the pigmented middle of the three concentric layers that make up an eye. The name is possibly a reference to its reddish-blue or almost black colour, wrinkled appearance and grape-like size and shape when...
of the eye
Human eye
The human eye is an organ which reacts to light for several purposes. As a conscious sense organ, the eye allows vision. Rod and cone cells in the retina allow conscious light perception and vision including color differentiation and the perception of depth...
is inflamed
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
.
Iridocyclitis is
Inflammation of the iris and the ciliary body.
Symptoms
Symptoms include:- PhotophobiaPhotophobiaPhotophobia is a symptom of abnormal intolerance to visual perception of light. As a medical symptom photophobia is not a morbid fear or phobia, but an experience of discomfort or pain to the eyes due to light exposure or by presence of actual physical photosensitivity of the eyes, though the term...
- RednessRed eye (medicine)In medicine, red eye is a non-specific term to describe an eye that appears red due to illness, injury, or some other condition. Conjunctivitis and subconjunctival hemorrhage are two forms of a red eye....
- Watering of the eyesTearsTears are secretions that clean and lubricate the eyes. Lacrimation or lachrymation is the production or shedding of tears....
- Lacrimation
- MiosisMiosisMiosis is the constriction of the pupil of the eye to two millimeters or less...
, constriction of the pupilPupilThe pupil is a hole located in the center of the iris of the eye that allows light to enter the retina. It appears black because most of the light entering the pupil is absorbed by the tissues inside the eye. In humans the pupil is round, but other species, such as some cats, have slit pupils. In... - Blurred visionBlurred vision-Causes:There are many causes of blurred vision:* Use of atropine or other anticholinergics* Presbyopia -- Difficulty focusing on objects that are close. The elderly are common victims....
- Synechia
Causes
Iridocyclitis is usually caused by direct exposure of the eyes to chemicals, particularly lachrymators, but can also be caused by ocular viral infection such as herpes zosterHerpes zoster
Herpes zoster , commonly known as shingles and also known as zona, is a viral disease characterized by a painful skin rash with blisters in a limited area on one side of the body, often in a stripe...
(i.e. herpetic iridocyclitis).
Can also be associated with juvenile idiopathic arthritis
Juvenile idiopathic arthritis
Juvenile idiopathic arthritis is the most common form of persistent arthritis in children. JIA is a subset of arthritis seen in childhood, which may be transient and...
(also known as juvenile rheumatoid arthritis). Seen usually with the pauciarticular type in females but polyarticular types are also at risk.
Acute or chronic
Acute: Sudden symptomatic onset, lasting no more than six weeks.Chronic: Persisting for more than six weeks, possibly asymptomatic. Chronic iridocyclitis is usually associated with systemic disorders including ankylosing spondylitis
Ankylosing spondylitis
Ankylosing spondylitis , previously known as Bekhterev's disease, Bekhterev syndrome, and Marie-Strümpell disease is a chronic inflammatory disease of the axial skeleton with variable involvement of peripheral joints and nonarticular structures...
, Behçet's syndrome
Behçet's disease
Behçet's disease is a rare immune-mediated systemic vasculitis that often presents with mucous membrane ulceration and ocular involvements...
, inflammatory bowel disease
Inflammatory bowel disease
In medicine, inflammatory bowel disease is a group of inflammatory conditions of the colon and small intestine. The major types of IBD are Crohn's disease and ulcerative colitis.-Classification:...
, juvenile rheumatoid arthritis, Reiter's syndrome, sarcoidosis
Sarcoidosis
Sarcoidosis , also called sarcoid, Besnier-Boeck disease or Besnier-Boeck-Schaumann disease, is a disease in which abnormal collections of chronic inflammatory cells form as nodules in multiple organs. The cause of sarcoidosis is unknown...
, syphilis
Syphilis
Syphilis is a sexually transmitted infection caused by the spirochete bacterium Treponema pallidum subspecies pallidum. The primary route of transmission is through sexual contact; however, it may also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis...
, tuberculosis
Tuberculosis
Tuberculosis, MTB, or TB is a common, and in many cases lethal, infectious disease caused by various strains of mycobacteria, usually Mycobacterium tuberculosis. Tuberculosis usually attacks the lungs but can also affect other parts of the body...
, and Lyme disease
Lyme disease
Lyme disease, or Lyme borreliosis, is an emerging infectious disease caused by at least three species of bacteria belonging to the genus Borrelia. Borrelia burgdorferi sensu stricto is the main cause of Lyme disease in the United States, whereas Borrelia afzelii and Borrelia garinii cause most...
.
Exogenous or endogenous
Exogenous: Related to external damage to the uvea or invasion of external microbesEndogenous: Related to internal microbes
Granulomatous or non-granulomatous
Granulomatous: Accompanied by large keratic precipitatesNon-granulomatous: Accompanied by smaller keratic precipitates
Treatment
Iridocyclitis can be effectively treated with tropane alkaloidTropane alkaloid
Tropane alkaloids are a class of alkaloids and secondary metabolites that contain a tropane ring in their chemical structure...
s or steroids.
To immobilize the iris
Iris (anatomy)
The iris is a thin, circular structure in the eye, responsible for controlling the diameter and size of the pupils and thus the amount of light reaching the retina. "Eye color" is the color of the iris, which can be green, blue, or brown. In some cases it can be hazel , grey, violet, or even pink...
and decrease pain, one may find tropane alkaloids effective, particularly scopolamine
Scopolamine
Scopolamine, also known as levo-duboisine, and hyoscine, is a tropane alkaloid drug with muscarinic antagonist effects. It is among the secondary metabolites of plants from Solanaceae family of plants, such as henbane, jimson weed and Angel's Trumpets , and corkwood...
and atropine
Atropine
Atropine is a naturally occurring tropane alkaloid extracted from deadly nightshade , Jimson weed , mandrake and other plants of the family Solanaceae. It is a secondary metabolite of these plants and serves as a drug with a wide variety of effects...
in .25% and 1% concentrations respectively. Topical steroids may be used to decrease inflammation, particularly prednisolone
Prednisolone
Prednisolone is the active metabolite of prednisone, which is also used as a drug.-Uses:Prednisolone is a corticosteroid drug with predominant glucocorticoid and low mineralocorticoid activity, making it useful for the treatment of a wide range of inflammatory and auto-immune conditions such as...
and dexamethasone
Dexamethasone
Dexamethasone is a potent synthetic member of the glucocorticoid class of steroid drugs. It acts as an anti-inflammatory and immunosuppressant...
. Upon presentation of a severe case, a subconjunctival steroid injection may be administered.