This document discusses chlamydial conjunctivitis, which is caused by the chlamydia organism. It can cause trachoma conjunctivitis, the world's leading cause of preventable blindness. Trachoma is characterized by follicular and papillary responses in the conjunctiva and causes scarring that can lead to blindness. It is diagnosed clinically and treated using the SAFE strategy. Adult inclusion conjunctivitis is another type of chlamydial conjunctivitis seen in sexually active young adults that presents with follicular hypertrophy and mucopurulent discharge.

1. CHLAMYDIAL CONJUNCTIVITIS
Saifullah

3. CHLAMYDIAL CONJUCTIVITIS
 This is a type of conjunctivitis caused by chlamydia.
 Chlamydia is neither a bacteria nor a virus but it
shares the properties of both the organisms.
 The group comprises of:
psittacosis.
Lymphogranuloma venereum
trachomatis

4. Life cycle of chlamydia

5. Ocular infections caused by chlamydia
 Trachoma conjunctivitis.
 Lymphogranuloma conjunctivitis.
 Psittacosis is associated with animals

6. TRACHOMA
 This is one of the leading cause of preventable
blindness in the world caused by chlamydia
trachomatis.
 it’s a chronic keratoconjunctivitis, primarily affecting
the superficial epithelium of conjunctiva and cornea
simultaneously.
 Its characterised by a mixed follicular and papillary
response of conjunctival tissue

7. trachoma

8. Trachoma conjunctivitis

9. Aetiology
 Its caused by a bedsonian organism, the chlamydia
trachomatis belonging to PLT group.
 It’s an epitheliotropic organism and produces
intracytoplasmic inclusion bodies called HP
BODIES(halbersteadter prowazek bodies)
 Serotypes: there are only 11 serotypes A-K but I
does not exists and Ba does exists.

11. Predisposing factors
 Age
 Sex
 Race
 Climate
 Socioeconomic status
 Environmental factors
source of infection
 Discharge from the eye of infected person, In
endemic area.

12. Modes of infection
 Direct spread
 Vector transmission
 Material transfer
Clinical features
These are described based on two phases
Viz;
- phase of active trachoma
- Phase of cicatricial trachoma

13. Phase of active trachoma
 Symptoms:
In the absence of secondary infection
-mild foreign body sensation
-occasionally lacrimation
-slight stickiness of the lid
-scanty mucoid discharge.
in the presence of secondary bacterial
infection
-acute mucoprulent discharge.

14. Signs of active trachoma
 Conjunctival signs
-congestion of upper tarsal and forniceal conjunctiva.
-conjunctival follicles
-papillary hyperplasia
 Corneal signs
-superficial keratitis
-Herbert follicles
-progressive pannus
-corneal ulcer

15. Phase of cicatricial trachoma
 Conjunctival signs
-conjunctival scarring
-concretions( of gland of henle)
-other conjunctival sequelae including
*concretions
*pseudocyst
*xerosis
*symblepharon

16. Artl’s line

18.  Corneal sign
*regressive pannus
*Herbert pits
*corneal opacity
*other corneal sequelae (blinding sequelae)
-corneal ectasia
-corneal xerosis
-total corneal pannus

20.  Lid signs.
*sequelae in the lids may be.
-trichiasis
-entropion
-tylosis
-ptosis
-madarosis
-ankyloblepharon
 lacrimal apparatus sequelae
*chronic dacryocystitis
*chronic dacryoadenitis

21. WHO grading of trachoma

22. Complications of trachoma
 The only complication of trachoma eye infection is
corneal ulcer which may occur due to rubbing by
concretions or trichiasis with superimposed
bacterial infection.
DIAGNOSIS
Diagnosis can be done based on its clinical signs and
clinical grading should be done as per W.H.O grading
into TF,TI,TS,TT or CO.

23. Laboratory diagnosis
 Conjunctival cytology
 Detection of inclusion body
 ELISA
 PCR
 Isolation of chlamydia
 Serotypes of TRIC agents using micro
immunofluorescence.

24. Differential diagnosis
 Trachoma with follicular hypertrophy
this has to be differentiated from acute adenoviral
follicular conjunctivitis. (epidemic
keratoconjunctivitis) as follows:
*distribution of follicles
*associated signs
*lab diagnosis
 Trachoma with predominant papillary
hypertrophy
This has to be differentiated from palpebral form of
spring catarrh as follows:

25. - Papillae are large in size and usually associated with
cobble-stone arrangement in spring catarrh.
-PH of tears is usually alkaline
-discharge is ropy
-conjunctival cytology should be well done.
-pannus and follicles are present in both.
Treatment of trachoma
SAFE treatment strategy

26. ADULT INCLUSION CONJUNCTIVITIS
 This is a type of acute follicular conjunctivitis
associated with mucoprulent discharge.
 It usually affects sexually active young adults.
 Its also called swimming pool conjunctivitis.
Aetiology
- serotype D to K of chlamydia trachomatis are assoc.
with inclusion conjunctivitis.
- Primary source in male is urethritis and cervicitis in
female
- Contaminated finger, water or swimming pool.

27. Clinical features
Symptoms
*ocular discomfort, foreign body sensation.
*mild photophobia
*mucoprulent discharge.
Signs
*conjunctival hyperemia
*acute follicular hypertrophy
*superficial keratitis
*preauricular lymphadenopathy

28. treatment
 Topical tetracycline 1% eye ointment 4/day x 6weeks
 Systemic drugs are:
- Azithromycin 1gm s.d
- tetracycline 250mg 4/day x3to 4 weeks
- Erythromycin as in above
- Doxycycline 200mg/week x 3 weeks.
Prophylaxis
*personal hygiene
*regular chlorination of water
*treatment of sexual partner.

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