Iritis

Iritis - Acute
Rahul Soman, M. Pharm

 

Definition  

Inflammation of the uveal layer of the anterior chamber of the eye. Sometimes the terms iritis and uveitis are used interchangeably; however, uveitis is a broader term referring to inflammation in the eye (anterior chamber, intermediate, posterior chamber, or panuveitis). More correctly, iritis is the same as acute anterior chamber uveitis . Chronic iritis is the result of recurring episodes of acute iritis.

 

Medical History  

* Injury of globe of eye

* Juvenile rheumatoid arthritis

* Behcet's syndrome

* Genetic predisposition

* Viral disease

* Bacterial infectious disease

 

Findings  

* Decreased intraocular pressure

* Fluorescein staining of cornea

* Light intolerance

* Pain of eye structure

* Raised intraocular pressure

* Anterior chamber finding

* Blurred vision

* Excessive tear production

* Limbal injection

* Miosis

* Reduced visual acuity

 

Tests  

 

Suspected and known iritis  

* Ocular slit lamp examination: Translucence of the aqueous humor (aqueous flare) and the presence of white blood cells in the anterior chamber are the sine qua non of iritis .

 

Differential Diagnosis  

* Glaucoma - Acute

* Corneal abrasion - Acute

* Keratitis

* Conjunctivitis

* Episcleritis

* Retinoblastoma

* Leukemia

* Malignant lymphoma of the eye region

* Retinitis pigmentosa

 

Treatment  

 

Drug Therapy  

 

Pain secondary to iritis  

 

HOMATROPINE HYDROBROMIDE  

Adults: Instill 1 drop of 2% or 5% solution in affected eye

 

CYCLOPENTOLATE HYDROCHLORIDE  

Adults: Instill 1 drop of 1% or 2% solution in affected eye

 

ACETAMINOPHEN/CODEINE PHOSPHATE  

Adults: Codeine 15 to 60 mg/acetaminophen 325 to 1,000 mg orally every 4 hours as needed (maximum 360 mg codeine and 4 g acetaminophen/day)

Pediatrics (3-6 years): 5 mL (12 mg codeine/120 mg acetaminophen per 5 mL) orally every 6 to 8 hours as needed

Pediatrics (7-12 years): 10 mL (12 mg codeine/120 mg acetaminophen per 5 mL) orally every 6 to 8 hours as needed

 

HYDROCODONE BITARTRATE/ACETAMINOPHEN  

Adults: Hydrocodone 5 to 20 mg/acetaminophen 325 to 1,000 mg orally every 4 hours as needed (maximum 4 g acetaminophen/day)

Pediatrics (2-13 years): 0.27 mL/kg (0.135 mg/kg hydrocodone and 9 mg/kg acetaminophen) orally every 4 hours as needed (maximum 6 doses/day)