Ask The Doctor: Rheumatoid Arthritis and Iritis

I have rheumatoid arthritis, and my doctor warned me to get checked for iritis. First, what is it, and second, is it dangerous?
By Paul S. Anderson, ND

Iritis is an inflammatory eye disorder that’s not caused by a viral or bacterial infection, and unfortunately, it’s one of the most dangerous kinds of “red eye” conditions you can have. A more common type, conjunctivitis (also called pink eye), is caused by either bacteria or viruses. Since doctors can swiftly treat conjunctivitis, many people believe that all red-eye conditions are essentially no big deal.

Nothing is further from the truth, however. With iritis, you basically have an eye that’s inflamed from the inside out, and that can lead to vision loss or blindness. Doctors most often see this condition in people with other chronic inflammatory disorders, such as rheumatoid arthritis, Crohn’s disease, and ulcerative colitis. Simply put, the deep, chronic inflammation occurring in your body eventually affects your eyes. As one patient described iritis, “It’s like having arthritis in my eye.”

The best treatment is prevention. Keep inflammation to a minimum—first by treating the underlying disease and second by watching what you eat. Choose a diet rich in whole grains, fruits and vegetables, lean proteins, and healthy fats (like olive oil), and steer clear of inflammatory fare, such as refined carbohydrates, processed meats, and foods high in sugar and fat (especially trans fats or foods loaded with omega-6 fatty acids).

You can also take other nutritional action to quell your too-active immune response: Stay hydrated by drinking at least eight glasses of water a day; supplement daily with at least 1,000 mg (up to 5,000 mg if possible) of EPA/DHA omega-3 fatty acids; and take 2,000 mg of vitamin C each day. I also recommend taking a multivitamin. As a further step, make an appointment with a naturopath or physician trained in naturopathic or functional medicine; he or she can assess your inflammation levels and tailor a regimen of herbs and nutrients specific to your condition and constitution. These measures will aid most in prevention, and if medical treatment becomes necessary, they will help you recover sooner.

That said, if you already have iritis, you must douse the inflammation as quickly as possible. This may entail taking steroids (either oral or as eyedrops) to save the eye from irreversible damage. Patients are shocked that I, a naturopathic doctor, support the use of steroids in these cases. But even though my therapies work wonderfully for prevention and for gradually reducing inflammation, they will do no good if your eye doesn’t work anymore. So a short treatment course with steroids can save your eyes, and then I can offer healing and natural anti-inflammatory options for prevention.

Pink Eye Versus Red Eye: Know the Difference

Conjunctivitis, or pink eye, classically appears as redness in the white of the eye away from the cornea and iris.

Numerous types of “red eye” exist, but some of them—iritis, corneal infection or ulcer, and acute glaucoma—require urgent medical care. These are usually marked by pain, vision change or loss, and redness that starts near the cornea and iris and spreads outward across the white of the eye.

Paul S. Anderson, ND, is a naturopath and teacher at Bastyr University School of Naturopathic Medicine.