Chlamydial conjunctivitis

This usually presents with generalised hyperaemia and profuse mucopurulent discharge. Itching is minimal.

The two principal forms are:

• inclusion conjunctivitis - in young sexually active adults - or in the infant - chlamydial ophthalmia neonatorum
• trachoma - principally a disease of the underdeveloped world
  • most common infectious cause of blindness (1)
  • caused by ocular serovars of Chlamydia trachomatis

Less often, chlamydia infection may present with conjunctivitis in psittacosis and lymphogranuloma venerum.

Chlamydia conjunctivitis is treated, in adults, with topical chlortetracycline ointment, applied three or four times per day, and a single 1 gram dose of azithromycin (2).

Reference:

1. Mabey DC et al. Trachoma. Lancet. 2003 Jul 19;362(9379):223-9.
2. Stamm WE et al. Azithromycin for empirical treatment of nongonococcal urethritis syndrome in men. A randomized doubleblind study. JAMA 1995; 274: 5459.