Chronic Iritis and Iridocyclitis

Chronic Iritis and Iridocyclitis

Epidemiology:

About one quarter of alliridocyclitiscases have a chronicclinical course.

Etiology:

See Table 8.1.

Symptoms:

See acute iridocyclitis. Chronic iridocyclitis may exhibit minimalsymptoms.

Diagnostic considerations:

See acute iridocyclitis.

Differential diagnosis:

The disorder should be distinguished from acuteglaucoma, conjunctivitis, and keratitis.

Complications:

Total obliteration of the pupil by posterior synechiae isreferred to a pupillary block. Because the aqueous humor can no longer circu-late, secondary angle closure glaucoma with iris bombé occurs. Occlusion of the pupil also results in fibrous scarring in the pupil. This can lead to thedevelopment of posterior subcapsular opacities in the lens (secondary cataract). Recurrent iridocyclitis can also lead to calcific band keratopathy.

Treatment:

In pupillary block with a secondary angle closure glaucoma, aNd:YAG laser iridotomy may be performed to create a shunt to allow theaqueous humor from the posterior chamber to circulate into the anterior chamber. In the presence of a secondary cataract, a cataract extraction may be performed when the inflammation has abated.

Prognosis:

Because of the chronic recurrent course of the disorder, it frequently involves complications such as synechiae or cataract that may progress to blindness from shrinkage of the eyeball.