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Adult inclusion conjunctivitis involving the superior and inferior tarsal conjunctiva.

  • 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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