Initial treatment of iritis which is not caused by a pathogen (virus, bacteria, mycobacteria, ureaplasma, yeast, mold or fungus) is through the use of topical corticosteroids. if adhesion is anticipated then a dilating drop is used to relax the ciliary body preventing the iris from adhering to the lens in a closed position.
Iritis that is stubborn, recurrent or chronic may require systemic treatment through the use of oral steroids, or other immunomodulating drugs. Some individuals will have genetic predisposition to uveitis which is related to autoimmune disease processes. The most common of these ‘genes’ is the HLA B27 Haplotype which can predispose to uveitis alone or also to the Seronegative Spondyloarthropathies and the enteropathic arthropathies. examples are Ankylosing spondylitis, Reactive arthritis (Reiters syndrome), psoriatic Arthritis, irritable Bowel disease and Crohn’s disease. there are other autoimmune disease processes also related to iritis/uveitis.
Multiple Sclerosis (HLA B15), Sarcoidosis, systemic Lupus Erythematosus, Lyme disease, Juvenile Ideopathic Arthritis. Sexually transmitted disease processes can also be related to uveitis as can Cat Scratch disease, Toxoplasmosis, toxocardia, Presumed Ocular Histoplasmosis syndrome, Lyme disease, whipples disease, valley fever, Tuberculosis, leptospirosis, Rocky Mountain Spotted fever etc.
Because of the relationship between Uveitis and over 90 different pathogens and autoimmune disease processes we suggest that individuals with recurrent or chronic uveitis be treated by an uveitis specialist or ocular immunologist. One may have to travel to see one of these very rare specialists but by doing so, the health of the patient as well as long term positive outcomes for the uvietic eye will occur. some of these consequences to lack of treatment or under treatment are: epiretinal membrane formation, cystoid Macular edema, cataracts, Glaucoma, detached retina, Vitreous hemorrhage, vascularization of the retina.
