Anterior uveitis, or iritis, is the medical term for
inflammation of the uveal tract. The eye's uveal tract is
composed of the iris, ciliary body and choroid. Anterior
uveitis is the most common type of uveitis and primarily
affects structures in the front of the eye. This condition
may be acute or chronic. The acute type is the most common
form of uveitis. It typically affects one eye and causes
pain, redness, light sensitivity, and blurred vision.
Chronic uveitis may be present even when the eye has a normal white appearance, and doesn't necessarily cause obvious symptoms. This type is most common among young children with juvenile rheumatoid arthritis. In most cases, anterior uveitis is caused by an autoimmune disorder, and research has found affected patients often have a genetic predisposition for the disease.
The white blood cell "marker" known as human leukocyte antigen B27 (HLA-B27) is present in only 1.4 to 6 percent of the general population, but is found in 50- 60% of patients with anterior uveitis. Frequently, the exact cause of anterior uveitis is unknown, but it may be associated with certain systemic diseases. These diseases are ruled out based on the patient's signs, symptoms, and response to treatment.
Reiter's syndrome: Presents with urethritis (burning sensation with urination, penile lesions), polyarthritis (arthritic symptoms in multiple joints), and iritis
Ankylosing spondylitis: Characterized by an inflammatory involvement of the sacro-iliac joints (low back, sacral area)
Ulcerative colitis (Crohn's disease): May cause recurrent abdominal discomfort and diarrhea
Psoriatic arthritis: Causes a combination psoriasis (skin disease) and arthritis Aortitis (inflammation of the aorta, the major artery from the heart): This is quite rare but may be life threatening
Juvenile rheumatoid arthritis
If any symptoms are present suggesting the possibility of an associated disease, a detailed work-up may be ordered, or the patient may be referred to a primary care physician for further evaluation. Patients with chronic anterior uveitis who either do not receive treatment or fail to respond to treatment, may develop posterior synechiae (scarring of the iris pupillary border to the natural lens of the eye), glaucoma, cataract, and vision loss.
Treatment is aimed at resolving the inflammation. Corticosteroid and dilating drops are commonly prescribed, along with glaucoma medication if the eye pressure becomes elevated. The goal of therapy is to eradicate all inflammation. As the steroids are slowly decreased, repeat examinations are necessary to identify signs and symptoms of a flare-up.