Iridocyclitis (Uveitis)

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Iridocyclitis
Iridocyclitis

Iridocyclitis (Uveitis) Meaning & Definition

The name iridocyclitis is rarely used in the English language and, as a medical condition, few people may have actually heard of it. In medical circles, the name is generally considered to be obsolescent along with the more general term for similar eye problems: ophthalmia but iridocyclitis remains a correct and specific medical term. As with many medical names, it originates from Greek with iris meaning rainbow, kiklos being a circle and it is denoting inflammation. The condition is sometimes regarded as being the same as iritis (inflammation of the iris) but iridocyclitis involves inflammation of both the iris and the ciliary body, which is the structure supporting and controlling the lens of the eye. In practice, most cases of iritis also involve some degree of inflammation of the ciliary body and only rarely is just the iris affected. The medical profession usually refer to inflammation of these structures of the eye as uveitis and when the front portion of the eye is affected, as in the case of iridocyclitis, this is normally termed anterior uveitis.

Iridocyclitis picture
Iridocyclitis

Iridocyclitis Symptoms

There are many conditions giving rise to sore eyes and it is important to differentiate between this and other conditions such as conjunctivitis which affects the outer surface of the white part of the eye along with the inner skin of the eyelids. Iridocyclitis will usually produce a similar bloodshot appearance but the coloured part of the eye, the iris, is involved along with parts of the internal eye structure. Redness, a burning pain and blurred vision are usually experienced along with headaches, photophobia (sensitivity to light) and “floaters” seen in the line of vision. The shape of the pupil may be irregular and in some cases, the sclera (the white section of the eye) may become completely obscured.

anterior uveitis photo
Anterior uveitis

Any episode of iridocyclitis should be considered to be a medical emergency and immediate help should be sought. A medical practitioner will carry out a detailed eye examination usually along with other tests in order to confirm the diagnosis and establish the appropriate methods of treatment. Iridocyclitis sometimes manifests itself in the form of keratic precipitates which appear as spots on the corneal endothelium. Recently formed “K.P.s” are usually white and of a round shape whereas those which arose some time ago are often more faded and irregular in shape. In the case of hemorrhagic (related to bleeding) uveitis, red “K.P.s” may be observed. Sometimes large greasy white “K.P.s” appear and are referred to as mutton-fat keratic precipitates. These are formed from macrophages and epithelioid cells and are normally due to granulomatous iridocyclitis. In addition to such “K.P.s”, some other signs of old uveitis include pigmented deposits on the eye lens or dilated pupils. Inflammatory nodules, known as Busacca nodules sometimes occur on the surface of the iris such as in cases of Fuch’s heterochromic iridocyclitis. This condition, as its name suggests, results in iris heterochromia (differing colours). It is generally considered to be a benign condition simply requiring monitoring for any future eye changes. It should be noted that there are many other completely harmless causes of heterochromia.

Iridocyclitis Causes

Iridocyclitis often occurs as an isolated incident with no recurrence of the condition but in some cases can be more chronic in nature. It is not always possible to ascribe a particular cause to an episode of iridocyclitis but it is known that the presence of certain antigens can result in a disposition to the condition. In particular, HLA – B27, which can be detected in the blood, increases the risk of iridocyclitis by around 15%. This type of iridocyclitis is much more common in males and is generally unilateral (affecting one eye) but with a tendency to alternate. It is non-granulomatous in appearance. Non-HLA – B27 iridocyclitis on the other hand equally affects both male and female patients and tends to be bilateral and more chronic in nature. It can be more granulomatous. Many other autoimmune conditions can increase the likelihood of developing this illness, one of the most common being rheumatoid arthritis. In Behcet disease, iridocyclitis is frequently accompanied by mouth and genital sores but it tends to be self-limiting clearing up by itself. Other autoimmune predisposing conditions include: systemic lupus erythematosus, sarcoidosis, spondyloarthritis, Crohn’s disease, granulomatosis with polyangiitis and sympathetic ophthalmia (where one eye suffers an injury and the other eye reacts to it). Iridocyclitis can also be caused by infections and clinicians will usually test for these. There are many possible causes but some of the most commonly encountered are: tuberculosis, toxocariasis, syphilis, Lyme disease, brucellosis, leptospirosis and Zika virus. Iridocyclitis can also develop as a side effect to certain drugs. In particular, it should be noted that all of the commonly used vaccinations list iridocyclitis as a possible side effect.

Iridocyclitis Diagnosis

Iridocyclitis is normally diagnosed by assessing the patient’s symptoms along with a detailed eye examination. This examination will also rule out other possible eye conditions such as posterior uveitis. Blood tests will usually be carried out checking for pathogens, antigens, or other immunological factors such as the rheumatoid factor. Scans or X-rays may be taken to check for the presence of pulmonary sarcoidosis or the presence of arthritis.

Iridocyclitis / Uveitis Treatment

The method of treatment will be determined by the causative factor, if known. For example, if the herpes simplex virus is involved, antiviral medication may be considered appropriate.

uveitis pic
Uveitis

Treatment frequently involves the administration of glucocorticoid steroids either orally or as eye drops. Prior to such treatment, checks should be carried out to ensure that no corneal ulcers are present (fluorescence test). Atropine or homatropine are also commonly used.

Iridocyclitis Prognosis

Iridocyclitis is a serious condition and a medical emergency. Without medical intervention it can cause serious damage to the eye, possibly resulting in the loss of sight. The good news is that, with proper treatment, a full and complete recovery is the usual outcome. The prognosis is therefore generally very good. The worst case scenario is that the illness may have resulted in some serious complications such as cataracts, glaucoma, macular oedema or band keratopathy.

Iridocyclitis kid Spelling Bee

On a lighter note, the word iridocyclitis is now much less obscure than it was in the past. The reason for this is that it featured in a TV spelling competition where a young kid from Mississippi was given this word to spell, presumably because no one had ever heard of it.

When Dev succeeded in the task, he achieved instant stardom and his performance, and the word went viral! It has since featured in pop songs and has even taken a place in the urban dictionary where its usual meaning is “I don’t believe my eyes”. However, it does not seem to have improved the world’s spelling and many online searches for young Dev’s performance are submitted as “iridosiklitis”.

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