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Iridocyclitis

What Is It, Causes, Diagnosis, Treatment, and More

Author:Georgina Tiarks

Editors:Alyssa Haag,Ian Mannarino, MD,Kelsey LaFayette, DNP, ARNP, FNP-C

Illustrator:Jessica Reynolds, MS

Copyeditor:Stacy M. Johnson, LMSW


What is iridocyclitis?

Iridocyclitis, a subtype of anterior uveitis, is a medical term describing inflammation of the vascular layer of the eye, which includes the iris and ciliary body. Uveitis is an inflammation of the uvea (i.e., middle layer of the eye) and may be divided into anterior and posterior uveitis. Anterior uveitis includes iritis (i.e., inflammation of the iris) and cyclitis (i.e., inflammation of the ciliary body). When both are inflamed, it is known as iridocyclitis. The iris is the colored ring of tissue in the eye, while the ciliary body includes the muscles and tissues extending from the posterior base of the iris that controls the shape of the lens (i.e., structure responsible for focusing light). The ciliary body also produces aqueous humor, a fluid that regulates intraocular pressure and provides nutrition to the anterior part of the eye.  

Posterior uveitis, on the other hand, may be defined as vitritis (i.e., inflammation of the vitreous body, also known as vitreous humor), choroiditis (i.e., inflammation of the choroid), and retinitis (i.e., inflammation affecting the retina). The vitreous body is the gel-like substance inside the eye; the choroid is the vascular layer of the eye between the retina and the sclera; and finally, the retina is a layer of tissue that converts light to nerve signals in the brain.

Anatomical view of the internal structures of the eye.

What is acute iridocyclitis?

Acute iridocyclitis describes iridocyclitis that occurs suddenly. Typically, acute iridocyclitis lasts for an average of three to six weeks but may persist for up to three months. If iridocyclitis lasts for more than three months, it is considered chronic.

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What causes iridocyclitis?

Iridocyclitis can have a variety of causes, such as infection, traumatic injury, systemic conditions, and allergies. Infections are most commonly caused by herpes simplex virus or varicella-zoster virus, though other infectious agents (e.g., syphilis, tuberculosis, cytomegalovirus, epstein-barr virus, rubella, ebola, West Nile virus, dengue virus, chikungunya virus, Rift Valley fever virus, influenza A virus, leptospirosis, toxoplasmosis, and toxocariasis) are among the many that can cause disease in immunocompromised or untreated individuals. Additionally, systemic conditions that cause iridocyclitis may include seronegative spondyloarthropathies (i.e., inflammatory arthritic conditions that include ankylosing spondylitis, psoriatic arthritis, and reactive arthritis), rheumatoid arthritis (i.e., an autoimmune condition affecting joints), sarcoidosis (i.e., an inflammatory disease causing noncaseating granulomas throughout the body), inflammatory bowel disease, and systemic lupus erythematosus (i.e., an autoimmune disease impacting multiple organ systems). Iridocyclitis may also be idiopathic (i.e., unknown).

What are the signs and symptoms of iridocyclitis?

The signs and symptoms of iridocyclitis may include blurred vision, eye pain, ocular hyperemia (i.e., red eyes), and vision loss. Some individuals may be sensitive to light, also known as photophobia. Epiphora (i.e., watery eyes) or hypopyon (i.e., pus in the eye) may rarely occur. Individuals may also experience swelling of the iris, which can sometimes be observed during the physical exam. They may also endorse seeing “floaters” in their vision.  

How is iridocyclitis diagnosed?

Iridocyclitis may be diagnosed after a thorough medical history and physical exam, followed by a slit-lamp examination allowing for a three-dimensional view of the eye. A conjunctival smear can be used to diagnose an infectious cause, while blood work, including inflammatory markers, a complete blood count (CBC), and specific antibodies (e.g., rheumatoid factor, antinuclear antibody, and anti-dsDNA antibodies) can help to diagnose systemic conditions. Genetic analysis may also be indicated for diagnosis of seronegative spondyloarthropathies.

How is iridocyclitis treated?

Treatment of iridocyclitis may depend on the underlying condition. Systemic or topical glucocorticoids may be useful to treat certain inflammatory diseases, such as systemic lupus erythematosus or rheumatoid arthritis. Cycloplegic mydriatics (i.e., medications that dilate the pupil), such as atropine or scopolamine, and analgesics may reduce pain. If iridocyclitis is caused by infection, antimicrobial therapy may be required.

If untreated, possible complications such as permanent vision loss, glaucoma (i.e., damage to the optic nerve), and cataracts (i.e., cloudy lens) may occur. 

What are the most important facts to know about iridocyclitis?

Iridocyclitis is an eye condition caused by inflammation of the iris and ciliary body, two structures in the anterior eye. Iridocyclitis can be caused by trauma, infection, systemic conditions, and allergies. This may result in blurred vision, eye pain, vision loss, and photophobia. A slit-lamp exam, conjunctival smear, and blood work can help to diagnose the underlying cause. Treatment largely depends on the underlying condition but may include glucocorticoids, mydriatics, analgesics, or antimicrobials. 

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Related links

Anatomy and physiology of the eye
Eye conditions: Inflammation, infections, and trauma: Pathology review
Uveitis

Resources for research and reference

Greenberg, R. D., & Dippold, A. L. (2017). Eye Emergencies. In C. K. Stone & R. L. Humphries (Eds.), CURRENT Diagnosis & Treatment: Emergency Medicine (8th ed.). McGraw-Hill Education. Retrieved from accessmedicine.mhmedical.com/content.aspx?aid=1176290285

Iridocyclitis. (2020). In Medicine.com. Retrieved March 2, 2022, from https://www.medicine.com/condition/iridocyclitis

Kim, E. C., & Margolis, T. P. (2006). Hypertensive iridocyclitis. The British Journal of Ophthalmology, 90(7), 812–813. DOI: 10.1136/bjo.2006.091876

Lin, P. (2015). Infectious Uveitis. Current Ophthalmology Reports, 3(3), 170–183. DOI: 10.1007/s40135-015-0076-6

Suneja, M., Szot, J. F., LeBlond, R. F., & Brown, D. D. (2020). The Head and Neck. In DeGowin’s Diagnostic Examination (11th ed.). McGraw Hill. Retrieved from accessmedicine.mhmedical.com/content.aspx?aid=1188265130