From the Guidelines
Iridocyclitis is a form of anterior uveitis characterized by inflammation of the iris and ciliary body, which can lead to serious morbidity, including loss of vision, if left untreated or not promptly managed. This condition is often asymptomatic, especially in children with juvenile rheumatoid arthritis (JRA), but can cause significant inflammation that affects the anterior chamber of the eye, leading to increased protein and inflammatory cells 1. The frequency of iridocyclitis in children with JRA varies from 2% to 34%, highlighting the importance of scheduled slit-lamp examinations by an ophthalmologist for early detection and treatment 1.
Key aspects of iridocyclitis include:
- Inflammation primarily affecting the iris and ciliary body
- Potential involvement of the choroid
- Asymptomatic in many cases, particularly in the context of JRA
- Serious morbidity possible, including cataracts, glaucoma, band keratopathy, phthisis bulbi, and loss of vision
- Importance of early detection through slit-lamp examination for preventing vision loss
Given the potential for severe complications, prompt treatment with corticosteroid eye drops and cycloplegic agents is crucial, along with regular follow-up to monitor the response to treatment and adjust the therapeutic approach as necessary. The underlying cause, such as autoimmune disorders or infections, should also be addressed to prevent recurrence or progression of the disease. In the context of JRA, the classification of the disease, including oligoarticular, polyarticular, and systemic onset types, may influence the risk and management of iridocyclitis 1.
Management strategies may include:
- Corticosteroid eye drops for reducing inflammation
- Cycloplegic drops to prevent ciliary muscle spasms and synechiae
- Oral anti-inflammatory medications for severe cases
- Regular ophthalmologic follow-up for monitoring and adjusting treatment
- Addressing underlying systemic diseases or infections contributing to iridocyclitis.
From the Research
Definition of Iridocyclitis
- Iridocyclitis is an inflammation of the iris and ciliary body, which are part of the uveal tract in the eye 2.
- It can occur in various forms, including acute and chronic, and can be associated with other conditions such as leprosy 3 and juvenile idiopathic arthritis 4.
Causes and Risk Factors
- The exact cause of iridocyclitis is not always known, but it can be triggered by infections, injuries, or autoimmune disorders 5, 6.
- Certain conditions, such as leprosy and juvenile idiopathic arthritis, can increase the risk of developing iridocyclitis 3, 4.
Symptoms and Complications
- Symptoms of iridocyclitis can include eye pain, redness, sensitivity to light, and blurred vision 3, 5.
- If left untreated or poorly managed, iridocyclitis can lead to complications such as ciliary body dysfunction, inadequate aqueous production, chorioretinal damage, and possibly blindness 2.
- Other complications can include glaucoma, cataracts, and vitreous infiltration 5.
Treatment and Management
- Treatment for iridocyclitis typically involves the use of corticosteroids, immunomodulatory agents, and other medications to reduce inflammation and prevent damage to the eye 4, 2.
- In some cases, surgery may be necessary to treat complications such as cataracts or glaucoma 5.
- Early treatment and regular follow-up care are important to prevent long-term damage and improve outcomes 4, 5.