ConditionEyes & vision
Traumatic Iritis
Traumatic iritis is inflammation of the iris, the colored part of the eye, after blunt injury such as a ball, fist, elbow or airbag striking the eye. Symptoms usually start 1 to 3 days after the injury: a deep aching eye pain, strong sensitivity to light, redness around the colored part of the eye, tearing and blurred vision. It needs an eye examination, because the same injury can cause bleeding inside the eye or retinal damage. With steroid and dilating eye drops, most cases settle within 1 to 2 weeks.
Also called: Post-traumatic iritis, traumatic anterior uveitis, traumatic iridocyclitis
At a glance
- What it is
- Inflammation of the iris and front of the eye after blunt trauma.
- Timing
- Symptoms typically begin 24 to 72 hours after the injury.
- Symptoms
- Aching eye pain, light sensitivity, redness around the cornea, tearing, blurred vision, small pupil.
- Diagnosis
- Slit-lamp exam showing inflammatory cells in the front chamber of the eye.
- Treatment
- Prescription steroid eye drops and dilating drops; most recover in 1 to 2 weeks.
When to get help
Call 911 or go to the ER
- Sudden vision loss, a misshapen pupil, or anything stuck in or penetrating the eye: protect the eye with a rigid shield and call 911 or your local emergency number
- Blood visible in the front of the eye, behind the cornea (possible hyphema)
- Severe eye pain with nausea, vomiting or halos around lights (possible high eye pressure)
- Flashes of light, a shower of floaters or a curtain over vision after an injury (possible retinal tear or detachment)
- Chemical splash to the eye: rinse with clean water for at least 15 minutes, then get emergency care
See a doctor within a day or two
- Eye pain, light sensitivity or redness starting within a few days after a blow to the eye
- Blurred vision or double vision after an eye injury
- Pain when looking at bright light with either eye after an injury
Book a routine appointment
- Light sensitivity or redness that returns after treatment ends
- Eye pressure checks after a previous eye injury, especially if vision changes
What happens in traumatic iritis
Traumatic iritis is a form of anterior uveitis caused by injury. A blunt blow compresses the eye. This can bruise the iris and the ciliary body (the muscle that focuses the lens). Inflamed tissue leaks white blood cells and protein into the aqueous fluid at the front of the eye. Under the slit lamp, an eye doctor sees these as "cells and flare," like dust in a beam of light.
The iris muscle spasms, causing pain, especially when the pupil reacts to light.
Symptoms
- deep, aching eye pain, often worse than expected for the visible injury
- light sensitivity (photophobia), including pain in the injured eye when light shines in the other eye
- redness concentrated in a ring around the cornea (ciliary flush)
- tearing
- blurred vision
- a smaller or sluggish pupil, or a pupil that is larger and irregular if the iris muscle was torn
- headache on the same side
Causes
Any blunt trauma to the eye:
- balls (baseball, racquetball, tennis, paintball)
- fists, elbows and assaults
- airbag deployment
- falls against objects
- workplace injuries, such as bungee cords and tools
Conditions to rule out
The same force that causes traumatic iritis can cause other injuries. An eye doctor will check for:
| Injury | Clues |
|---|---|
| Corneal abrasion | Scratchy foreign-body sensation; shows with fluorescein dye |
| Hyphema | Blood layering behind the cornea; risk of high pressure |
| Traumatic glaucoma | Raised eye pressure, immediately or years later |
| Traumatic cataract | Clouding of the lens |
| Retinal tear or detachment | Flashes, floaters, curtain over vision |
| Orbital fracture | Double vision, numb cheek, sunken eye |
| Open globe injury | Misshapen pupil, leaking fluid, severe vision loss |
Diagnosis
- visual acuity check
- pupil and eye movement examination
- slit-lamp examination to see cells and flare in the front chamber
- eye pressure measurement
- dilated examination of the retina, once safe
- imaging (CT) if an orbital fracture or foreign body is suspected
Treatment
Treatment is prescribed by an eye care professional:
- Steroid eye drops reduce inflammation and are tapered over 1 to 2 weeks or more.
- Cycloplegic (dilating) eye drops relax the iris and focusing muscle, relieving pain and preventing the iris from sticking to the lens.
- Pain relief: acetaminophen (paracetamol) is often preferred initially if there is a possibility of bleeding inside the eye; follow the label dose.
- Sunglasses for light sensitivity.
- Follow-up visits to check that inflammation is settling and eye pressure stays normal, because steroid drops can raise eye pressure.
Do not use leftover steroid drops or someone else's eye drops without examination; steroids can worsen some eye infections and injuries.
Recovery
Most traumatic iritis improves within days of starting treatment and resolves in 1 to 2 weeks. Some people need treatment for longer. Follow-up eye exams are important because traumatic glaucoma can develop months or years after an injury that damaged the drainage angle of the eye.
Prevention
- wear protective eyewear for racquet sports, baseball, paintball and hockey (sports goggles with polycarbonate lenses)
- use safety glasses for work with tools, machinery or chemicals
- secure bungee cords carefully
Frequently asked questions
What is traumatic iritis?
Traumatic iritis is inflammation of the iris after a blunt injury to the eye. It causes aching pain, light sensitivity, redness around the colored part of the eye and blurred vision, usually beginning 1 to 3 days after the injury.
How long does traumatic iritis last?
With treatment, most cases improve within a few days and clear in 1 to 2 weeks. Steroid drops are usually tapered gradually. Some people need longer treatment if inflammation persists.
Why does my eye hurt in bright light after being hit?
Light makes the pupil constrict, which moves the inflamed iris and causes pain. This is typical of traumatic iritis. Light shining into the uninjured eye can also cause pain, because both pupils react together.
Can traumatic iritis go away on its own?
Mild cases may improve without treatment, but an eye exam is important to rule out more serious injuries, and treatment relieves pain and prevents complications such as the iris sticking to the lens. Prescription drops are usually recommended.
Can traumatic iritis cause permanent damage?
Most people recover fully. Long-term problems are usually caused by other injuries from the same trauma, such as damage to the eye's drainage system, which can lead to glaucoma years later. Regular follow-up eye exams help catch this early.
Sources
This guide was written from current patient and clinical guidance, including:
- American Academy of Ophthalmology: Traumatic iritis; Uveitis
- American Academy of Ophthalmology EyeWiki: Traumatic iritis
- MedlinePlus: Eye injuries
- American Academy of Family Physicians: Eye trauma - diagnosis and management in primary care
- Prevent Blindness: Sports eye safety