Chlamydia conjunctivitis (ophthalmoclycemia): symptoms and treatment

Chlamydial conjunctivitis refers to the infectious infection of the mucous eye with chlamydia, which is accompanied by inflammation of the conjunctiva. Due to the progression of this ailment, transitional folds and conjunctiva swell and inflame, purulent exudate from the eyes. One of the most characteristic symptoms of an ailment is the appearance of rashes localized in the lower eyelid.



Chlamydial conjunctivitis in the medical literature is also referred to as chlamydiosis of the eye or ophthalmic chlamydia. This type of ailment is about 3-30% of the total number of conjunctivitis of various etiologies. Most often they are sick people between the ages of 20 to 30 years. This is due to the fact that it is during this period is the most active sexual life. It is worth noting the fact that women are infected with chlamydial conjunctivitis more often than representatives of the stronger sex.

Chlamydial conjunctivitis usually begins to progress against the background of existing urogenital chlamydia.

Pathogen

The main causative agent of Chlamydia conjunctivitis is Chlamydia trachomatis. Its peculiarity is that the microorganism has the ability to form specific L-forms, therefore chlamydia can for a long time freely parasitize inside cells, being in the so-called «sleeping» state. The reversal of chlamydia from inactive forms occurs under the influence of such unfavorable factors:


  • overheating and hypothermia
  • long-term use of antimicrobials
  • ARVI
  • infectious ailments
  • immunosuppression period.

As a result of the negative impact, chlamydia begin to actively multiply and affect certain areas of the human body. In the case of chlamydial conjunctivitis, the mucous membrane of the eye «attacks» and, consequently, clinical symptoms appear.

The type of lesion depends on the type of antigenic serotype.


  1. serotypes A, B, Ba and C provoke the progression of trachoma
  2. D-K serotypes are the main cause of development of parathrachoma, urogenital chlamydiosis, and chlamydial conjunctivitis
  3. L1-L3 serotypes are the cause of inguinal lymphogranulomatosis.

Ways of infection


  • Chlamydial conjunctivitis begins to progress due to the transfer of the pathogen to the conjunctiva. This becomes possible through the hands or hygiene items that have been contaminated with excreta containing the causative agent. In medicine, cases where ocular clamidiosis is a consequence of oral-genital sexual contacts with a partner already infected with chlamydia are not uncommon.
  • This ailment can develop against the background of an already existing autoimmune disease. In this case, we are talking about Reiter’s syndrome. But it is worth noting that the pathogenesis of chlamydial conjunctivitis in this case has not yet been fully studied by clinicians.
  • Professional infection with chlamydia. There are also known cases when ophthalmologists, obstetrician-gynecologists, venereologists, andrologists-andrologists were infected with an ailment — all those people who, due to their professional activities, regularly examine patients with various forms of chlamydia.
  • You can get infected even if you visit public saunas, baths or swimming pools. Doctors refer to this form of illness as a «bathhouse.»
  • Chlamydial conjunctivitis in newborns. They become infected transplacental or during the passage of the baby through the birth canal of the infected mother.

Classification

There are several forms of chlamydial conjunctivitis in patients:


  1. trachoma;
  2. paratrahoma
  3. Blenorrhea
  4. Chlamydial conjunctivitis in children
  5. Chlamydia eye in Reiter’s syndrome;
  6. Chlamydiosis of the eye of zoonotic nature.

Symptoms

Symptoms of the disease begin to manifest themselves actively only after the expiration of the incubation period. In this case, it is from 5 days to 2 weeks. Most often, an ailment «attacks» first one eye, but also meets bilateral infection. In most clinical situations, the ailment occurs in the form of acute or subacute eye infection. But if the pathology is not timely detected and cured, then it can go into a chronic form.

A chronic course is characterized by a lingering course. Symptoms of pathology are not pronounced. The patient has relapses of blepharitis or conjunctivitis. The main symptoms: a small edema of the eyelids, mucous discharge from the eyes, as well as hyperemia of the conjunctival tissues.

The remission period is not long. Exacerbation of the disease occurs due to the adverse effects of external factors, such as hypothermia, alcohol, spicy food, etc.

Acute symptoms are characterized by the following symptoms:


  • swelling of the eye mucosa
  • lacrimation
  • itching and pain in the eyes;
  • secretion of a purulent secret from the eyes
  • tinnitus
  • Multiple follicles and fibrinous membranes are noted on the conjunctiva. Data of education dissolves without the appearance of scars.

The acute variant, as a rule, runs from 2 weeks to 3 months.

Diagnostics

The standard diagnostic program includes:





  1. ophthalmological examination
  2. laboratory tests
  3. consultative reception with narrow specialists

The main role in diagnosing an illness belongs to the laboratory method of research:


  • determination of blood antibodies (ELISA)
  • cytological examination
  • Immunofluorescence analysis
  • PCR
  • culture analysis

Only after a thorough diagnosis and evaluation of the test results, the doctor will be able to prescribe adequate treatment for the disease.

Treatment

It is important to diagnose the pathology in time and to conduct competent treatment to prevent the degeneration of the acute form into a chronic one. Antimicrobials are prescribed in a mandatory manner. Complete recovery of the patient is possible only with systemic treatment for half a year or a year. During this time, all the symptoms of pathology will disappear and the available follicles will dissolve.


  1. systemic treatment for this type of chlamydia is carried out according to the scheme used to treat STIs
  2. Local treatment. Such therapy is also extremely important, since it helps to reduce the present unpleasant symptoms. The patient is prescribed eye drops of antibacterial action, ointment applications, anti-inflammatory drops.

Treatment can be called successful only if:


  • Symptoms are not present
  • negative laboratory tests were obtained.

It is important to remember that with the development of this pathology, treatment should be prescribed only by a highly qualified specialist. Self-cure pathology will not succeed, but you can only complicate its course. Treatment is carried out only in a stationary environment.

Complications


  1. trichiasis;
  2. Xerosis;
  3. baldness of the eyelid
  4. fusion of the eye and eyelid membranes;



  5. blindness.