Iritis Overview for Medical Practitioners
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Questions and Answers

What is a characteristic symptom of conjunctivitis?

  • Deep visceral pain
  • Pupil mid-dilated and non-reactive
  • Preauricular lymph node swelling (correct)
  • Unilateral eye redness only

    • Which symptom differentiates a foreign body sensation from an actual foreign body in the eye?

  • Presence of opacification
  • Localized redness around corneal area
  • Circumcorneal injection
  • Absence of actual foreign body (correct)

    • What is the typical pupil reaction observed in acute angle closure glaucoma?

  • Constricted and reactive
  • Mid-dilated and non-reactive (correct)
  • Normal and reactive
  • Dilated and reactive

    • In which condition are circumcorneal vessels typically normal?

    <p>Conjunctivitis (A)</p> Signup and view all the answers

    What is a notable sign of corneal ulcers compared to iritis?

    <p>Corneal opacification (C)</p> Signup and view all the answers

    Which ocular condition is most likely to lead to nausea?

    <p>Acute angle closure glaucoma (A)</p> Signup and view all the answers

    What differentiates herpes keratitis from iritis in terms of pupil reaction?

    <p>Pupil is usually normal (B)</p> Signup and view all the answers

    A patient with a foreign body in the eye is likely to experience which type of discomfort?

    <p>Instant discomfort worsening with eye movement (D)</p> Signup and view all the answers

    What are the common symptoms of iritis?

    <p>Watery red eye, pain, photophobia (A)</p> Signup and view all the answers

    What ocular sign is typically associated with iritis?

    <p>Circumcorneal injection (C)</p> Signup and view all the answers

    Which condition is NOT commonly associated with systemic illness in patients with iritis?

    <p>Systemic lupus erythematosus (A)</p> Signup and view all the answers

    What is typically observed during the examination of a patient with iritis?

    <p>Clear cornea with a small pupil (C)</p> Signup and view all the answers

    How should vision be tested in a patient suspected of having iritis?

    <p>In a darkened room to reduce discomfort (B)</p> Signup and view all the answers

    What is a sign of posterior synechiae in a patient with iritis?

    <p>Irregularities of the dilated pupil (D)</p> Signup and view all the answers

    What might patients do to alleviate symptoms of pain associated with iritis?

    <p>Keep their eyes closed or wear sunglasses (D)</p> Signup and view all the answers

    What is the typical time frame for the onset of symptoms in patients with iritis?

    <p>Over 24 to 48 hours (C)</p> Signup and view all the answers

    Flashcards

    Iritis

    Inflammation of the iris, the colored part of the eye. Characterized by pain, redness, and blurry vision.

    Posterior Synechiae

    Adhesions between the posterior surface of the iris and the anterior surface of the lens. These adhesions prevent the pupil from dilating fully.

    Photophobia

    A condition where the eye is very sensitive to light and the pupil is constricted.

    Conjunctivitis

    A condition where the eye is red and irritated due to inflammation of conjunctiva, the thin transparent membrane that lines the inner surface of the eyelid.

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    Corneal Opacification

    A condition where the cornea, the transparent outer layer of the eye, is cloudy and the vision is blurred.

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    Mydriasis

    A condition in which the pupil is dilated and sluggish in response to light.

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    Keratitis

    Inflammation of the cornea, the transparent outer layer of the eye. Often caused by an infection or injury.

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    Elevated Intraocular Pressure

    A condition where the eye is very hard to the touch when pressed, usually due to increased pressure inside the eye.

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    What is Iritis?

    Inflammation of the iris, the colored part of the eye.

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    What are the main symptoms of Iritis?

    A watery red eye, pain, and sensitivity to light (photophobia).

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    What is ciliary or circumcorneal injection?

    Redness around the edges of the iris.

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    What are posterior synechiae?

    Adhesions between the iris and the lens.

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    What are keratic precipitates?

    Deposits of inflammatory cells on the cornea.

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    What medical history should you consider for patients with Iritis?

    A medical history including diseases like ankylosing spondylitis, inflammatory bowel disease, tuberculosis, or sarcoidosis.

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    Why is pupil dilation important in Iritis diagnosis?

    Dilating the pupil helps with diagnosis because it allows better observation of the iris and potential synechiae.

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    How to approach a patient with a history of Iritis presenting with red eye?

    Patients with a history of Iritis should be considered to have a recurrence until proven otherwise.

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    Study Notes

    Iritis

    • Iritis is a common intraocular inflammation, often causing a red eye.
    • GPs should consider this diagnosis in any patient with a red eye.
    • History: Many patients with iritis have had it before, and experience symptoms before noticeable signs. This recurring pattern is key. Principal symptoms include a watery, red eye, pain (deep and dull), and photophobia (light sensitivity) which usually develops over 24-48 hours. Patients with iritis often keep their eyes closed or wear sunglasses.. Vision is usually mildly decreased.
    • Medical history is important: About 10% of iritis patients have a systemic condition. Specifically inquire about conditions like ankylosing spondylitis, inflammatory bowel disease, tuberculosis, and sarcoidosis.
    • Examination:
      • Vision: Assessing vision can be difficult due to photophobia. Testing in a darkened room or after pupil dilation often improves results.
      • Eye: Redness is typically concentrated at the limbus (ciliary or circumcorneal injection) which overlies the inflamed iris. The cornea is usually clear, and the pupil is frequently small unless prevented by synechiae (adhesions).
      • Dilated examination: Dilating the pupil is helpful. Look for posterior synechia (adhesions between the iris and the lens surface) as signs of previous or current iritis. Keratic precipitates (inflammatory cell deposits on the corneal endothelium) can sometimes be seen against the red reflex from a dilated pupil during examination.

    Differential Diagnosis

    • Foreign Body: Foreign bodies usually cause immediate, worsening discomfort with blinking. There's no circumcorneal injection (redness around the cornea's edge), but redness may be localized near the foreign body. Be aware of patients describing foreign body sensation without a visible foreign body.
    • Conjunctivitis: Generally bilateral. Visual changes are less pronounced in conjunctivitis, and blood vessel engorgement is usually more prominent in the conjunctival fornix. It is commonly associated with upper respiratory infections and preauricular lymph node swelling.
    • Herpes Keratitis: Patients typically present with a history of ocular herpes. The eye is visibly more pink-red than in typical iritis. The pupil is usually normal, but a fluorescein stain can reveal an ulcer in the cornea.
    • Acute Angle-Closure Glaucoma: This condition affects mostly the elderly. Deep, visceral pain, mid-dilated and unresponsive pupils, a cloudy cornea, and poor vision are common, along with possible nausea. The affected eye is hard, when palpated.
    • Corneal Ulcer: Main sign is corneal opacity. Hypopyon (pus in the front of the eye) is more common than in iritis.

    When to Refer

    • All patients with iritis should be referred to an ophthalmologist.
    • Recurrent iritis patients can be started on treatment in consultation with an ophthalmologist but should be reviewed within 48 hours.

    Key Points

    • Suspect iritis in any patient with a unilateral red eye.
    • A history of previous iritis plus symptoms or signs of eye inflammation strongly suggests a recurrence until proven otherwise.
    • Cardinal signs of iritis include a watery eye, peri-corneal injection, pinpoint pupils, photophobia, and mild visual loss.

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    Iritis: The Eye in General Practice PDF

    Description

    This quiz covers the key aspects of iritis, a common intraocular inflammation leading to red eye symptoms. It emphasizes the importance of medical history and the typical examination process, highlighting systemic conditions that may be associated with iritis. Understand the principal symptoms and diagnostic considerations critical for general practitioners.

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