Basics of Traumatic IritisWhen a person experiences trauma to the eye, usually from a blunt force, the iris can be shaken up or traumatized. In some cases, the iris can be torn, cut or bruised, causing it to function abnormally. The main job of the iris is to control the amount of light that enters the eye: it dilates and contracts, becoming larger and smaller, much like a camera diaphragm. When the iris is injured, it becomes inflamed, and when the inside of the eye is inflamed, the body rushes white blood cells to the area to mend the problem and speed up healing.
While this process sounds like a good thing, the inflamed cells make it very sticky inside the eye, sometimes causing part of the iris or other parts of the eye to stick together, causing further damage. Also, the fluid in the front part of the eye, the aqueous humor, can fill with inflammatory cells and sometimes pigment or blood from the trauma, causing it to thicken. The thickened liquid may not be filtered out of the eye fast enough, causing eye pressure to rise to dangerous levels. On the contrary, sometimes the ciliary body is also traumatized, causing reduced eye pressure. Although this usually doesn’t lower eye pressure to dangerous levels, it is something that eye doctors pay close attention to.
Symptoms of Traumatic IritisTraumatic iritis can sneak up on you, often times not producing symptoms for 2-3 days after receiving trauma to the eye. Symptoms of traumatic iritis may include any or all of the following:
- eye ache or pain
- sensitivity and pain when exposed to light
- blurry vision
Diagnosis of Traumatic IritisBesides taking a careful medical history, your eye doctor will thoroughly examine your eyes. Your visual acuity will be measured, and your pupils will be tested. Sometimes, even before symptoms develop, pupil size may be unequal between the eyes. Your eye doctor will also measure the pressure inside your eye, and examine your eye with a special high powered microscope, known as a slit lamp biomicroscope. Using a slit lamp, doctors can visualize the front part of the eye, carefully noting trauma.
One sign your eye doctor will look for specifically is inflammatory cells floating around in the fluid in the front part of your eye. Normally, these cells are absent. Your eye doctor will also dilate your pupils to view the optic nerve, blood vessels and retina. Trauma to the eye increases the risk of developing retinal tears or detachments, and even optic nerve disease from the blunt, concussive force to the eye.
Treatment of Traumatic IritisAfter any severe trauma to the eye is ruled out, your doctor will begin to treat iritis. Because people often have significant pain with this condition, a cycloplegic drop is given that dilates the pupil and temporarily paralyzes the ciliary body. This prevents the spasm that occurs in the ciliary body, which is usually the cause of pain. This eye drop also keeps things from sticking and binding together, causing further damage.
To control the inflammatory response, steroid eye drops are prescribed. Steroid eye drops are sometimes used very frequently at first, and then tapered to just a few drops per day as the eye heals. You may also be advised to limit aspirin-type products, as sometimes a traumatic hyphema may be present. A traumatic hyphema is bleeding in the front part of the eye that can thicken and cause further complications. Most uncomplicated cases of traumatic iritis usually last between 1-2 weeks.
Catania, Louis J. Primary Care of the Anterior Segment, Second Edition, Copyright 1995 by Appleton & Lange, pp