Irisitis uveitis

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit



Arthritis can affect the eye in a number of ways. One way is by causing uveitis. Uveitis means "inflammation of the uvea", or the middle layer of the eye.

Inflammation in uveitis may involve any but not necessarily all of these three structures. Depending upon which structures are inflamed, uveitis may be further subcategorized into one of three main diagnoses, these include:

-iritis or anterior uveitis,
-iridocyclitis or intermediate uveitis, and
-choroiditis or posterior uveitis.


In the majority of cases there is no specific cause. Occasionally, iritis is just one symptom of a disease that affects other organ systems. These are called connective tissue diseases and include: rheumatoid arthritis, sarcoid , lupus , scleroderma , Behcet's disease , anklylosing spondylitis, Reiter's disease, Crohn's disease, ulcerative colitis, and B-27 disease. Sometimes, it is necessary to establish whether iritis/uveitis is a manifestation of one of these or some other underlying systemic disease. Your eye care provider may ask a detailed medical history, and may order a battery of tests including several possible blood tests, a chest x-ray, x-rays of the lower back, and a skin test for tuberculosis.

Uveitis may develop following eye trauma or surgery, in association with diseases which affect other organs in the body, or may be a condition isolated to the eye itself. Severe and permanent visual loss can result from uveitis. In addition, uveitis can lead to other ocular complications, which may produce vision loss, including glaucoma, cataracts, or retinal damage. Early detection and treatment is necessary to reduce the risk of permanent vision loss.

The symptoms of iritis usually appear suddenly and develop rapidly over a few hours or days.The symptoms of iritis include light sensitivity, red eye, blurred vision, tearing, pain, and sometimes floaters. The pupil may appear small in the affected eye when compared to the normal pupil. Frequently iritis is a recurrent problem; after a few episodes patients become very astute at early diagnosis. Iritis is sometimes confused with conjunctivitis, a much less serious disorder of the clear outer lining of the eye.

Treatment may include steroid eyedrops, injections, or pills, as well as eyedrops to dilate the pupil and reduce pain.

The secrets to the successful treatment of iritis is early detection and proper choice of medicines. Therapy consists of anti-inflammatory and dilating drops. These medicines decrease the inflammation and reduce the scarring that can occur. Persistent cases may require more intensive treatment. Successful treatment of iritis depends on careful and consistent compliance by the patient.

In serious cases, complications may arise. Cataracts, glaucoma, and corneal changes are possible consequences of both the disease and the medicines used to treat it. Careful observation is needed in the resolving phase to monitor potential problems. If the medicines are withdrawn too rapidly, a recurrence is very possible. More severe cases of uveitis may even require treatment with chemotherapeutic agents to suppress the immune system. This is particularly true with severe types of arthritis conditions.

Drugs that have been used have been corticosteroids, methotrexate, sulfasalazine, azathioprine, and biologic agents such as etanercept (Enbrel), adalimumab (Humira), and infliximab (Remicade).

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