Iritis: A Case study

INTRODUCTION

The iris is a circular, pigmented membrane that provides the eye its color and forms the pupil of the eye.The iris is made up of muscular fibers that control the amount of light entering the pupil so that we can see clearly. The iris accomplishes this task by making the pupil smaller in bright light and larger in dim light. In some people, the iris can become inflamed. This is termed iritis.

Where in, Iritis is inflammation predominantly located in the iris of the eye. Often, iritis can't be linked to a specific cause. But sometimes, iritis results from an underlying chronic condition or genetic factor. Also referred to as anterior uveitis, iritis is a serious condition that, if left untreated, could lead to blindness. If you have symptoms of iritis, see your doctor as soon as possible for evaluation and treatment.

Inflammation in the iris is more correctly classified as anterior uveitis.The ciliary body can also be inflammed and this would then be called iridocyclitis. The problem usually affects only one eye and, with treatment, should clear up in a week or two.

Iritis usually starts as an infection in another part of the body that moves to the eye. It sometimes occurs as a result of a disease or an eye injury. Often the cause is unknown. When the iris is inflammed, white blood cells (leukocytes) are shed into the anterior chamber of the eye where they can be observed on slit lamp examination floating in the convection currents of the aqueous humor. These cells can be counted and form the basis for rating the degree of inflammation.

Since iritis is an inflammation inside the eye, the condition is potentially sight threatening. Proper diagnosis and prompt treatment of iritis are essential. To minimize any loss of vision, the patient should have a complete eye examination as soon as symptoms occur. If diagnosed in the early stages, iritis can usually be controlled with the use of eye drops before vision loss occurs.

ANATOMY AND PHYSIOLOGY

The iris is the colored part of the eye. As light conditions change, the iris may dilate to make the pupil bigger or constrict to make the pupil smaller. This allows more or less light into the eye.

The eye is a complex organ composed of many parts. Good vision depends on the way in which those parts work together. It is helpful to understand how the eye works before learning about macular degeneration.

The human eye is the organ which gives us the sense of sight, allowing us to observe and learn more about the surrounding world than we do with any of the other four senses.  We use our eyes in almost every activity we perform, whether reading, working, watching television, writing a letter, driving a car, and in countless other ways.  Most people probably would agree that sight is the sense they value more than all the rest.

The eye allows us to see and interpret the shapes, colors, and dimensions of objects in the world by processing the light they reflect or emit.  The eye is able to detect bright light or dim light, but it cannot sense objects when light are absent.

Process of vision

Light waves from an object (such as a tree) enter the eye first through the cornea, the clear dome at the front of the eye.  The light then progresses through the pupil, the circular opening in the center of the colored iris.

Fluctuations in incoming light change the size of the eye’s pupil.  When the light entering the eye is bright enough, the pupil will constrict (get smaller), due to the pupillary light response.

Initially, the light waves are bent or converged first by the cornea, and then further by the crystalline lens (located immediately behind the iris and the pupil), to a nodal point (N) located immediately behind the back surface of the lens.  At that point, the image becomes reversed (turned backwards) and inverted (turned upside-down).

The light continues through the vitreous humor, the clear gel that makes up about 80% of the eye’s volume, and then, ideally, back to a clear focus on the retina, behind the vitreous.  The small central area of the retina is the macula, which provides the best vision of any location in the retina.  If the eye is considered to be a type of camera, the retina is equivalent to the film inside of the camera, registering the tiny photons of light interacting with it.

Within the layers of the retina, light impulses are changed into electrical signals.  Then they are sent through the optic nerve, along the visual pathway, to the occipital cortex at the posterior (back) of the brain.  Here, the electrical signals are interpreted or “seen” by the brain as a visual image.

Actually, then, we do not “see” with our eyes but, rather, with our brains.  Our eyes merely are the beginnings of the visual process.

HEALTH TEACHINGS

Stress the importance of the following:

To maintain fluid and electrolytes balance:

Monitoring for fluid and electrolytes balance
Assess intake and output every 8 hours.
Weigh patient daily.
Assess presence and extent of edema.
Encouraging patient to increase fluid intake.

To prevent infection and injury:

Maintaining good personal hygiene.
Avoiding stress which can aggravate symptoms.
Encouraging activity within prescribed limits but avoid fatigue.
Protecting from injury when carrying out activities.
Protecting patient from exposure to infectious agents.
Maintaining good asepsis during treatments and procedures.
Encouraging proper diet.

To promote comfort:

Medicating patient as needed for pain.
Providing comfort measures like massage and changing of position.
Encouraging rest for fatigue.
Providing calm, supportive environment.

To assist with coping in life-style and self-concept.

Promoting hope
Providing opportunity for patient to express feelings about self.