The anterior chamber, the space between the cornea and iris, is filled with a clear fluid called aqueous humor that nourishes the eye’s internal structures. Normally, this fluid is transparent. The presence of cells within the aqueous humor is an abnormal finding that indicates an inflammatory response inside the eye. These cells are white blood cells, a sign that the body’s immune system has been activated and that an underlying health issue requires medical evaluation.
Associated Symptoms
The inflammation that brings cells into the anterior chamber produces distinct symptoms. A person may experience a persistent, aching pain within the eye. Another common symptom is photophobia, a sensitivity to light that occurs because the inflamed iris struggles to contract properly. Vision may become blurred or cloudy as the suspended cells interfere with light passing through the aqueous humor. The eye often appears red, and in some instances, the eyelids may also become swollen or watery.
Underlying Causes of Cellular Presence
The most frequent cause for cells in the anterior chamber is uveitis, which is inflammation of the eye’s middle layer, the uvea. Uveitis can be triggered by several factors, including direct trauma, infections, or systemic autoimmune conditions. In autoimmune cases, the body’s immune system mistakenly targets its own tissues, such as in rheumatoid arthritis and Behçet’s disease. In North America, a leading cause is HLA-B27-associated acute anterior uveitis, an immune disorder for which a person can be genetically predisposed. Sometimes, no specific origin can be identified, and the condition is classified as idiopathic.
The Diagnostic Process
An ophthalmologist identifies cells in the anterior chamber through a comprehensive eye examination, with the slit-lamp examination being the primary tool. A slit-lamp is a high-magnification microscope combined with a high-intensity light source. The thin beam of light illuminates the aqueous humor, making any suspended inflammatory cells visible. This phenomenon is often described as resembling dust particles floating in a sunbeam. To quantify the extent of the inflammation and monitor the effectiveness of treatment, clinicians grade the concentration of cells on a standardized scale from 1+ to 4+, which provides an objective measure of the severity.
Common Treatment Approaches
Treatment for cells in the anterior chamber is focused on two main goals: reducing the inflammation and addressing the underlying cause. The primary therapy for controlling inflammation involves corticosteroid eye drops, such as prednisolone acetate, which are applied directly to the eye. These drops work to suppress the local immune response and decrease the number of inflammatory cells. The frequency of application depends on the severity of the inflammation.
To manage pain and prevent complications, doctors prescribe cycloplegic eye drops. These medications dilate the pupil, which helps to ease the discomfort caused by iris spasms and reduces the risk of the iris adhering to the lens, a complication known as posterior synechiae. Managing the root cause of the inflammation is also necessary. This could involve antiviral medications for a herpes infection or systemic immune-suppressing drugs for an autoimmune disorder. Regular follow-up appointments are necessary to ensure the inflammation is subsiding and to monitor for any potential complications.