Traumatic iritis

Revision as of 13:48, 8 November 2015 by Rossdonaldson1 (talk | contribs)

Background

  • Blunt trauma: contusion and spasm of ciliary body and iris
  • Iridocyclitis because both the iris and the underlying ciliary body are inflamed
  • Iritis
    • HLA-B27 antigenic marker also strongly linked to spondyloarthritis such as ankylosing spondylitis

Clinical Features

  • Eye pain
  • Decreased visual acuity in affected eye
  • Photophobia (direct and consensual)
  • Sluggish pupil
  • Cell & flare
    • “Cell:” individual cells floating in the anterior chamber (look like dust specks)
    • “Flare:" protein floating in the anterior chamber from inflamed blood vessels. (smoke)
  • Hypopyon (severe cases): leukocytic exudate in anterior chamber

Differential Diagnosis

Diagnosis

Treatment

  1. Cycloplegics (eg. homotyptine 5%, or cyclopentolate 2%, 3 times per day until ophthalmology follow-up): paralyzes the ciliary body resulting in a nonreactive, dilated pupil
  2. PO analgesia
  3. Steroids in consult with optho (rule out infection first)

Disposition

F/u with optho in 24-48 hours

See Also

References

  • PEER VIII Q&A
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