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Welcome to question of the day #87
A 30-year-old male patient presents with a unilateral red eye and blurred vision in that eye with onset one day ago. The patient is photophobic and has a small pupil in eye that is red. He denies having any previous episodes. What is going on?
The main ingredients here are a recent red eye, light sensitivity and a small pupil all in the same eye. This sounds very much like anterior uveitis also known as iritis.
Iritis is inflammation of the iris and has several possible causes:
Eye injury
Infection from bacteria, viruses, parasites, or fungi
Inflammatory autoimmune diseases, such as ankylosing spondylitis, lupus, sarcoidosis, and juvenile idiopathic arthritis
Injury
Reactions to medicines
Leukaemia
Kawasaki syndrome (lymph node disease in young children).
Eye complications can cause permanent loss of vision:
Abnormal adhesion of the iris to other eye structures (synechiae)
Cataracts
Calcium deposits on the cornea (band keratopathy)
Inflammation of the vitreous
Inflammation of the retina
Optic nerve damage in severe cases, causing blindness
Glaucoma
Macular oedema.
Recent onset iritis is an ocular emergency and the patient deserves immediate referral to an ophthalmologist.