Iritis is inflammation of the iris. Symptoms include a painful, red and photophobic eye. Pain and photophobia can be significant. Pain is typically described as an ache and felt behind the eye or over the eyebrow. The inflammation can lead to decreased vision and epiphora. There is typically no discharge and no itch. Refer to optometrist/ophthalmology if suspected
Blood tests and a chest X-Ray are carried out in patients with recurrent iritis or in cases of bilateral iritis. In many cases no cause is found but it can be linked to certain rheumatological conditions and some infections.
If a patient has had iritis before and they develop a red, painful and photophobic eye they should be referred urgently for assessment to start treatment promptly. The aim is to prevent posterior inflammation and retinal necrosis. Every patient with iritis will have a dilated fundoscopy carried out so please advise patients to avoid driving to appointments. We also wish to avoid posterior synechiae developing. These are adhesions of the iris to the lens. This makes the pupil irregular and non/poorly reactive and contributes to the pain.
Management is initially ophthalmology led. Treatment is usually with frequent topical steroids and patients usually start on a slowly reducing regimen. Initial treatment can include cyclopentolate to relax the iris and reduce pain.
Who to refer:
Please see Lothian GP and optometry ophthalmology referral pathway.
Urgency of the condition for details on how soon patients should receive an appointment.
Patients who present with a problem with their only seeing eye should be advised to see an optician/ophthalmologist for review.
How to refer:
We require a referral letter for EVERY patient.
The preferred referral process is via SCI Gateway. If sending/forwarding a referral via SCI gateway please include past medical history, allergies and medications
If you do not have access to fax or SCI Gateway e.g. if you have arranged an appointment out of hours please send a written referral letter with the patient to bring to their appointment.
Only if SCI Gateway is unavailable should a letter be typed or handwritten. Please write legibly and include your examination findings.
If you have arranged an appointment in the acute referral clinic and you are referring from within another hospital in Lothian please use TRAK to type the referral letter.
