- Most common manifestation of ocular chlamydial infection in sexually
active young adults.
- Clinical features:
- Symptoms: acute or subacute in onset and include ocular irritation,
foreign body sensation, watering, mucopurulent discharge and sticking
of the lids
- Signs:
- Often appears as unilateral disease
- Usually presents with red eye, swollen lids or chemosis
- May have palpable uni- or bilateral pre-auricular nodes
- Follicles tend to occur in the inferior fornix (predilection
area), however a mixed follicular and papillary response may
also develops in the superior tarsal conjunctiva
- Corneal involvement:
- Subepithelial infiltrates
- Mild superficial keratitis
- History of sexual activity and previous sexually transmitted disease
is important
- May be complicated with corneal neovascularization and/or conjunctival
scaring
- Conjunctival follicles or corneal infiltrates may persist for months
- Management:
- Combined topical and systemic antibiotics are necessary
- Systemic antibiotics include doxycycline or tetracycline (contraindicated
in pregnant women) or azythromycin in adult patients
- Sexual contact should also be treated with full course of therapy
- Signs and symptoms usually improve over 2-4 weeks
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