A 30-year-old male patient presents with a unilateral red eye and blurred vision in that eye with onset one day ago. The patient is photophobic and has a small pupil in the eye that is red. He denies having any previous episodes. What is going on?
The main ingredients here are recent red-eye, light sensitivity and a small pupil all in the same eye. This sounds very much like anterior uveitis also known as iritis.
Iritis is inflammation of the iris and has several possible causes:
- Eye injury
- Infection from bacteria, viruses, parasites, or fungi
- Inflammatory autoimmune diseases, such as ankylosing spondylitis, lupus, sarcoidosis, and juvenile idiopathic arthritis
- Reactions to medicines
- Kawasaki syndrome (lymph node disease in young children).
Eye complications can cause permanent loss of vision:
- Abnormal adhesion of the iris to other eye structures (synechiae)
- Calcium deposits on the cornea (band keratopathy)
- Inflammation of the vitreous
- Inflammation of the retina
- Optic nerve damage in severe cases, causing blindness
- Macular oedema.
Recent onset iritis is an ocular emergency and the patient deserves immediate referral to an ophthalmologist.