Iritis

Iritis is an eye condition that is caused by the inflammation in the iris of the eye. Iris is a circular, colored, front portion of the eye, surrounding the dark pupil. Iris is filled with muscular fibers which regulate the amount of light entering the pupil. It allows the pupil to contract in bright light and enlarges it in dim light. When this iris becomes inflamed, it is termed as iritis or anterior uveitis, whereas the inflammation at the back of the eye is called posterior uveitis. Iritis causes severe pain, light sensitivity and may even lead to sight loss on rare occasions.

What causes iritis ?

Iritis can occur in one or both the eyes. The causes to iritis can be traumatic or non traumatic. Iritis caused by the trauma or injury to the eye is called traumatic iritis. Infections such as shingles or syphilis can lead to iritis or uveitis. Iritis may also occur due to certain autoimmune diseases present in the body like Ankylosing spondylitis, reactive arthritis, psoriatic arthritis, irritable bowel disease and tuberculosis. This condition is known as Non traumatic iritis. In most cases, it becomes difficult to find the cause for iritis.

Symptoms of iritis

The symptoms of the iritis surface suddenly and initially it affects one eye. Some of the symptoms of iritis are mentioned below:

• Redness in the eye, especially adjacent to the iris
  
• Deep eye pain, becomes worse when exposed to the light
  
• Light sensitivity
  
• Blurred vision
  
• Irregularly shaped pupil
  
• Headache
  

Treating iritis

Iritis, if left untreated, may give rise to complications such as cataract, glaucoma, retinal detachment and vision loss. Hence it is advisable to seek medical help on finding any of the symptoms. Firstly, the ophthalmologist makes a complete note of your medical history and conducts a thorough eye examination. A slit light is focused on the affected eye to have a better view of the structure and any signs of inflammation. Since iritis is associated with some autoimmune diseases, your doctor may advise few tests to find out the exact cause.

Your eye doctor will prescribe dilating eye drops - Cycloplegics to dilate your pupil and relieve you of the pain. These drops also prevent the scarring of the pupil. Patients complaining of sensitivity to light will be given dark glasses. Steroid eye drops and antibiotics also may be given to reduce the inflammation. These drops settle the cell membrane and regulate the movement of the white blood cells in your eye. If the problem persists or worsens you may be given oral steroids, injections and other anti inflammatory drugs.

Normally, traumatic iritis disappears with proper and timely treatment, but, chances of recurring cannot be ruled out in case of non-traumatic iritis. In such cases, the relapse of iritis depends upon how well the underlying causes are diagnosed and treated.

Bleeding in the Eye

Bleeding in the eyes is associated with many underlying conditions like hyphema, blood vessel damage (subconjuctival hemorrhage), diabetic retinopathy and vitreous hemorrhage.

The conditions for diabetic retinopathy occur because of long term diabetics. Prolonged high blood sugar levels can damage the blood vessels associated with the retina of the eye. These blood vessels become leaky or clogged. The leaky blood vessels initiate the process of hemorrhages which are visualized as spots of bleeding. In some instances the clogged blood vessels obstruct the supply of oxygen to the retina causing ischemic condition. Maintaining proper blood sugar levels along with controlled pressure is essential.

Subconjuctival hemorrhage occurs due to damage caused to the sclera or the white portion of the eye. The blood released because of the damaged blood vessel is trapped under the conjunctiva. Subconjuctival hemorrhage associated eye bleeding is often painless. It is mainly caused because of high blood pressure and also triggered by cough, vomiting and sneezing. The blood spots disappear gradually. Medical attention is required if symptoms such as blurred vision, pain and recurrent hemorrhages occur. The choice of medication given for subconjunctival hemorrhage are blood thinners like heparin and Coumadin.

Hyphema is caused due to injury to the eye. The trauma caused in the eye can be of blunt or closed types depending upon the intensity of the damage. Most of these traumas which result in the bleeding of the eye are because of external sources such sharp objects, industrial chemicals, fumes, injuries associated with boxing and martial arts. Smaller hyphemas are associated with bleeding and swelling of the eye and extreme hyphemas are associated with pain, bleeding, swelling and reddening of the entire eye. The diagnosis for hyphema is usually performed by an ophthalmologist evaluating the entire history of the case followed by series of visual acuity tests. A CT scan is also recommended if there is a suspicion of bone damage in the eye region caused because of trauma.

Vitreous hemorrhage is another predominant cause for eye bleeding. Other factors include tumors adjacent to the vitreous humor of the eye and macro aneurysms. The treatment options for vitreous hemorrhages include vitrectomy and through Krypton laser therapy.

Rare causes for bleeding in the eye

Apart from the common factors that are associated with the hemorrhages caused in the eye, some rare conditions such cancers and iritis also cause bleeding in the eyes. Cancers of the eye are usually diagnosed by biopsy and also by careful visual examination. Since the symptoms of the bleeding eye disease may mask the diagnosis of underlying cancer or tumor, malignancy is confirmed by pathologic determination. Iritis is caused because of the inflammation in the iris of the eye. It may be the result of a trauma caused to the eye or underlying systemic conditions such as sarcoidosis and tuberculosis. Analgesics are recommended for common iritis. Patients are advised to wear dark sunglasses.

Syphilis

Syphilis is a sexually transmitted bacterial infection or STD. It is caused by Treponema pallidum, a spiral-shaped bacterium. It can affect both men and women who are sexually active. Syphilis can be transmitted from an infected person to another during oral, anal and vaginal sex and oral-genital contact. It can also be passed on by direct skin contact with someone who has syphilis sores or a syphilis rash and by sharing sex toys. Syphilis can also be transmitted by blood transfusion. Those who have tested positive for syphilis are vulnerable to other STD like Gonorrhea and HIV.

Syphilis develops in stages. Not everyone will go through all the stages. Between the stages are periods that are symptom-free or latent periods. When the infection is active, symptoms are noticeable. When it's not active, the symptoms are unnoticeable but syphilis persists.

Primary syphilis: Syphilis is highly contagious during the first stage. The incubation period is around 21 days before the first signs and symptoms appear. A painless red sore called a chancre appears on the part of the body like vagina, rectum, penis or mouth, places where the spirochetes moved from the infected person to another. The painless sore isn't noticed or recognized most of the time and the infected individual may not fall ill. The chancre may heal after 4 to 6 weeks but it does not indicate that syphilis has actually gone away. It continues to spread throughout the body.

Secondary syphilis: The bacterial has spread into the bloodstream. Without treatment, blood-borne spread of Treponema pallidum over the next several weeks to months results in secondary syphilis. It usually occurs 2 to 8 weeks after the appearance of chancre sore and several weeks after chancre have healed. Symptoms include fever, multiform skin eruptions, iritis, alopecia, mucous patches and severe pain in the head and joints. The signs and symptoms of secondary syphilis will resolve with or without treatment, but without treatment, the infection will progress to the latent stage of disease.

Latent (hidden) syphilis: The signs of the disease may go away, but the disease is present in the body. Syphilis can remain latent for many years.

Tertiary syphilis: Also termed as late-stage syphilis, tertiary syphilis may occur many years after the original infection. The infection has already spread all over the body and can affect the brain, heart, spinal cord and bones. Symptoms vary depending on which organ is infected and affected.

Congenital syphilis: A pregnant syphilis infected woman may pass on the infection through the placenta to the child during fetal development or delivery which is referred to as congenital syphilis. If the infected pregnant woman is not treated before 18th week of pregnancy, the child is most likely to be affected with congenital syphilis. Some babies with congenital syphilis have no symptoms at birth but develop them in a few weeks if not treated immediately. As a precautionary measure, syphilis screening tests (VDRL, RPR, FTA-ABS) has been made a routine part of prenatal care during pregnancy.

Jarisch Herxheimer Reaction: A temporary reaction to penicillin treatment for syphilis that manifests in the form of fever, chills and skin rash or chancre.