Ophthalmologic Manifestations of Chlamydia Clinical Presentation

Updated: Oct 04, 2018
  • Author: Mounir Bashour, MD, PhD, CM, FRCSC, FACS; Chief Editor: Hampton Roy, Sr, MD  more...
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Presentation

History

Adult inclusion conjunctivitis presents as a unilateral (or less commonly bilateral) red eye with mucopurulent discharge, marked hyperemia, papillary hypertrophy, and a predominant follicular conjunctivitis.

Women often have a concomitant vaginal discharge secondary to chronic vaginitis and/or cervicitis. Men may have symptomatic or nonsymptomatic urethritis.

Conjunctivitis often is chronic and may last for many months.

Inquire about duration of symptoms, prior treatment, and recent and not-so-recent sexual exposure.

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Physical

Inferior tarsal conjunctival follicles are obvious, and a tender enlarged preauricular lymph node is common.

Keratitis may develop during the second week after onset.

Corneal involvement includes a superficial punctate keratitis, small marginal or central infiltrates, epidemic keratoconjunctivitis (EKC)–like subepithelial infiltrates, limbal swelling, and a superior limbal pannus. [3] The subepithelial infiltrates tend to be more peripheral than after EKC.

Untreated disease has a chronic remittent course, and keratitis and possibly iritis occur more commonly in the late stage of disease.

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Causes

Adult inclusion conjunctivitis is a sexually transmitted disease.

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