Uveitis vs Iritis - Differences

Uveitis

It is a general term which refers to inflammation of the uvea (the middle layer of the eye). It can affect people of any age, however, onset typically occurs in the 3d and 4th decades of life.

Around 35 percent of patients with uveitis exhibit visual impairment or blindness in at least one eye. Also, in the United States, uveitis is believed to be the cause of up to 10 percent of legal blindness.

Types

There are different types of inflammation of the uvea depending on the location of the inflammation:

  • panuveitis – it is the term which describes the presence of inflammation both at the front and the back of the eye;
  • posterior uveitis – it occurs when the inflammation affects the layers at the back of the eye like the choroid, or the retina;
  • intermediate uveitis – it refers to the inflammation affecting the vitreous humor (the clear gel that fills the space between the retina and the lens);
  • anterior uveitis (better known as iritis) – when the inflammation is located in the ciliary body or in the iris.

Symptoms

Symptoms include:

  • loss of peripheral vision (the capacity to see objects at the side of your field of vision);
  • small shapes moving across your field of vision;
  • eye pain – typically a dull ache in or around your eye, that may be worse on focusing;
  • cloudy or blurred vision;
  • sensitivity to light (photophobia);
  • eye redness.

Complications

Possible complications of uveitis include:

  • loss of vision;
  • permanent damage of the eye;
  • retinal damage;
  • glaucoma (the leading cause of irreversible blindness in the world).

Tip

To help reduce your chance of complications from uveitis, take the following steps:

  • practice safe sex, in order to avoid infections;
  • to prevent the spread of infection to the eye, wash hands regularly;
  • follow all treatment instructions;
  • see your eye doctor right away if you have symptoms of inflammation of the uvea.

Causesd

It can be caused by:

  • Tuberculosis;
  • Ankylosing spondylitis;
  • Toxoplasmosis (a parasitic disease caused by Toxoplasma gondii);
  • Psoriasis;
  • Syphilis;
  • Ulcerative colitis (an inflammation of the large intestine);
  • Kawasaki disease;
  • Sarcoidosis;
  • Histoplasmosis;
  • Rheumatoid arthritis (a long-term autoimmune disorder that mainly affects joints);
  • Herpes zoster infection;
  • Reactive arthritis;
  • Cytomegalovirus (CMV) Retinitis (a serious viral eye infection of the retina);
  • AIDS.

Risk Factors

Risk factors for developing uveitis may include:

  • use of the following drugs – flurbiprofen, prostaglandin analogs, brimonidine, rifabutin, metipranolol, moxifloxacin, sulfonamides, bisphosphonates, or cidofovir;
  • acute posterior multifocal placoid pigment epitheliopathy;
  • Vogt-Koyanagi-Harada syndrome (a bilateral granulomatous panuveitis without or with extraocular manifestations);
  • TINU syndrome (a rare oculorenal inflammatory condition);
  • CMV retinitis;
  • sympathetic ophthalmia (a bilateral granulomatous inflammation which follows surgical or accidental insult to the uvea of one eye);
  • necrotizing herpetic retinitis (a serious infection of the retina which is caused by one of the human herpesviruses);
  • autoimmune scleritis (an inflammation in the episcleral and scleral tissues);
  • punctate inner choroidopathy (an inflammatory disease affecting the retina and choroid).

Diagnosis

Your healthcare provider will do a full eye examination. If he suspects that you have inflammation of the uvea, you might also need:

  • photography of the retina;
  • blood tests;
  • photography of the blood flow within the eye;
  • testing the fluid of the eye.

Treatment

Treatment may include:

  • treatment of an underlying condition – this inflammation may be a sign of an undiagnosed infection or disease somewhere else in the body;
  • cycloplegic medication – it involves the use of eye drops which dilate the pupil to prevent it from sticking to the lens of the eye;
  • corticosteroids – most patients with inflammation of the uvea respond to steroid eye drops.

Iritis

Image credit – https://commons.wikimedia.org/wiki/File:Iritis.jpg

It is an inflammation of the iris, the colored part of the eye (available in three main colors – green, blue, and brown). The iris controls light which enters the eye by controlling the size of the eye’s opening.

Symptoms

Symptoms may include any or all of the following:

  • headache;
  • pain in the brow or eye region;
  • blurred vision;
  • funny or small shaped pupil;
  • reddened eye, particularly adjacent to the iris;
  • worsened eye pain when exposed to bright light.

Complications

Inflammation of the iris may cause many ocular problems, including:

  • calcium accumulation on the cornea (band keratopathy);
  • swelling in the back of the eye (macular edema);
  • iris attachments to the lens (posterior synechiae);
  • inflammation in the retina (retinitis);
  • inflammation in the vitreous (vitritis);
  • glaucoma;
  • cataracts (any cloudiness or opacity of the natural lens of the eye).

Causes

It may be a complication of a variety of diseases, like:

  • lupus;
  • sarcoidosis;
  • tuberculosis;
  • ankylosing spondylitis;
  • juvenile rheumatoid arthritis.

In addition, it may be caused by an infection of the eye from trauma.

Risk Factors

You have a higher risk of developing an inflammation of the iris if you:

  • have a specific genetic alteration;
  • develop a sexually transmitted infection;
  • have an autoimmune disorder;
  • have a weakened immune system;
  • smoke tobacco and second=hand smoking.

Diagnosis

Your healthcare professional will conduct a complete eye exam, including:

  • slit-lamp examination;
  • visual acuity;
  • external examination.

Treatment

Image credit – https://commons.wikimedia.org/wiki/File:Ciclosporin_eye_drops_(in_water).jpg

To prevent damage to the eyes, treatment should be done quickly. Treatments may include:

  • steroid medicines to treat inflammation;
  • antibiotics to treat a bacterial infection of the eye;
  • immunosuppressive medicines, such as etanercept or cyclosporine;
  • eye drops to dilate the eye;
  • antiviral medicines to treat a viral infection of the eye.

Bottom Line – Uveitis vs Iritisd

Uveitis is inflammation in the middle part of the eye. It is the 5th leading cause of vision loss in the US. Over 39,000 cases happen every year in the United States. Common symptoms of uveitis include:

  • floaters (spots seen in the visual field);
  • painful eye;
  • cloudy vision;
  • sensitivity to light (increased pain when eyes are exposed to light);
  • bloodshot eye.

Iritis, also known as anterior uveitis, is inflammation which affects the colored ring around your eye’s pupil. Symptoms of iritis can include:

  • uneven pupil sizes between the two eyes;
  • severe eye pain;
  • the eye may appear swollen;
  • eye redness;
  • blurred vision;
  • excessive tearing;
  • photophobia (sensitivity to light);
  • eye soreness.

In conclusion, iritis is the most common form of uveitis, a condition which is commonly associated with autoimmune disorders, especially arthritis.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5357029/
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4455042/
https://jamanetwork.com/journals/jamaophthalmology/fullarticle/1735103