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Iritis is a complicated disease that can lead to other long-term ocular complications, such as glaucoma.
In fact, studies have shown that 35% to 50% of patients with a low-grade uveitis may develop glaucoma during a 10-year-period.¹
Sometimes, you need a "big gun" to quell the inflammation associated with iritis. For that reason, initial
treatments with a strong steroid, such as Durezol (difluprednate, Alcon) q.i.d. or Pred Forte
(prednisolone acetate, Allergan) q1h or q2h, are necessary. (If you select Durezol, simply prescribe
half the dosage for half the treatment time you would normally recommend if you had selected Pred Forte.)
Once you note significant improvement of cell and flare, begin a slow taper. Remember, the initial treatment
dosing should be sufficiently aggressive to reduce the risk of chronic inflammation.
Cycloplegia with 5% homatropine is also an ideal treatment approach. Twice-a-day dosing will prevent synechiae,
restore vascular permeability to the iris vessels, and minimize the pain associated with iridocyclitis.
To prevent a low-grade smoldering iritis, you must treat beyond the cell and flare. In other words, if you
taper corticosteroids too quickly in any case of iritis—especially a case associated with a systemic condition,
such as Crohn's disease, sarcoidosis or ankylosing spondylitis—low-grade anterior chamber inflammation could
linger dormant or even "reignite." By maintaining prolonged steroid dosing—even as conservatively as q.d.—for one
week after cell and flare are no longer evident in the anterior chamber, you can help prevent a rebound iritis.
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