The eye is painful, especially when attempting to view near objects, but the pain is never so severe as to cause vomiting. The cornea remains bright and the pupil tends to go into spasm and is smaller than on the normal side (Figure 7.4). Acute iritis is seen from time to time mainly in the 20-40-year age group, whereas acute glaucoma is extremely rare at these ages. Unless severe and bilateral, acute iritis is treated on an outpatient basis with local steroids and mydria-tic drops. Some expertise is needed in the use of the correct mydriatic, and systemic steroids should be avoided unless the sight is in jeopardy. Because the iris forms part of the uvea, acute iritis is the same as acute anterior uveitis. In many cases, no systemic cause can be found but it is important to exclude the possibility of
sarcoidosis or ankylosing spondylitis. The condition lasts for about two weeks but tends to recur over a period of years. After two or three recurrences there is a high risk of the development of cataract, although this might form slowly.
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