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Chlamydial conjunctivitis

Chlamydial conjunctivitis /opthalmochlamydiosis, chlamydiosis of the eyes/ makes up 3-30% of cases of different etiology of this disease. Chlamydia of the eyes occurs most often in people between the ages of 20 and 30, and women are affected 2-3 times more often than men.

Chlamydial conjunctivitis occurs mainly against the background of urogenital chlamydiosis /urethritis, colpitis, cercivitis/ and may manifest itself in a latent form and cause no complaints.

What are the causes?

Chlamydial conjunctivitis is caused by the intracellular microorganism Chlamydia trachomatis, which simultaneously exhibits antigenic properties of both bacteria and viruses.

Forming the so-called L-forms, chlamydiae are capable of prolonged intracellular parasitism in an inactive, “dormant” state. Under different types of adverse conditions such as taking antibiotics, hypothermia, overheating, acute respiratory viral infections, in a period of immunosuppression, there is an “awakening” reversion of chlamydia from L-forms and active reproduction with the development of clinical symptoms.

Different antigenic serotypes of chlamydia cause different diseases – for example, serotypes A, B, Ba and C lead to the development of trachoma, serotypes D-K to the occurrence of paratrichomes in adulthood, epidemic chlamydial conjunctivitis, urogenital chlamydiosis , and serotypes L1-L3 to the development of chlamydial lymphogranulomatosis.

In most cases, chlamydial conjunctivitis occurs against the background of chlamydia of the urogenital tract – according to statistics, about 50% of patients with ophthalmic chlamydia also have the urogenital form of the infection.

In adults, ocular chlamydia develops as a result of the mechanical transfer of the causative agent of the infection from the genitals to the conjunctival sac through contaminated objects and hands.

At the same time, the carrier of urogenital chlamydia can infect not only his visual organs, but also those of his partner. Often chlamydial conjunctivitis is a consequence of oral-genital sexual contact with an infected partner.

There are known cases of occupational infection with ocular chlamydia among obstetricians-gynecologists, venereologists, urologists-andrologists, ophthalmologists examining patients with various forms of chlamydial infection.

Contagion with chlamydial conjunctivitis is also possible through the water when visiting public pools and baths. This form of the disease has received the name “pool” or “toilet” conjunctivitis and can often acquire an epidemic character.

Chlamydial conjunctivitis can accompany the course of the autoimmune disease – Reiter’s syndrome, however, the pathogenesis of ophthalmic chlamydia in this pathology has not been fully studied.

Ocular chlamydia in newborns can develop as a result of intrauterine / transplacental infection or infection of the eyes during childbirth from a mother with chlamydia. Chlamydial eye infection occurs in 5-10% of newborns.

What are the symptoms?

Clinical manifestations of chlamydial conjunctivitis develop after the incubation period of 5-14 days. Usually one eye is affected at first, bilateral infection is found in 30% of cases.

In 65% of those who develop this infection, it takes the form of an acute or subacute eye infection, and in the remaining cases – in a chronic variant.

Treatment of chlamydial conjunctivitis

The drugs used in this disease are the following antibiotics – fluoroquinolones, macrolides, tetracyclines.

Local treatment includes the application of antibacterial eye drops / ofloxacin solution, ciprofloxacin solution/, the application of eyelid ointments – tetracycline and erythromycin ointment, anti-inflammatory drops – indomethacin and dexamethasone solution are also applied.

The systemic treatment of chlamydiosis is carried out according to the scheme for the therapy of sexually transmitted infections.

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