Chlamydia, a prevalent sexually transmitted infection (STI), can cause pink eye, also known as conjunctivitis. This bacterial infection, caused by Chlamydia trachomatis, is typically associated with the genital area but can affect various parts of the body, including the eyes. When chlamydia affects the eyes, it leads to inflammation of the conjunctiva, the clear membrane lining the inside of the eyelids and covering the white part of the eye.
How Chlamydia Leads to Eye Infection
Chlamydial conjunctivitis primarily develops when Chlamydia trachomatis bacteria transfer from infected genital secretions to the eyes. This often occurs through direct hand-to-eye contact after touching infected bodily fluids. The infection almost always spreads from the genital area to the eyes, with eye-to-eye transmission being rare.
Beyond self-transmission in adults, newborns can also be affected during childbirth if the birthing parent has an untreated genital infection. As the baby passes through the birth canal, they can contract the bacteria, leading to ophthalmia neonatorum. Sharing contaminated items like towels or cosmetics can also spread the bacteria to the eyes.
Recognizing Symptoms and Seeking Care
Symptoms of chlamydial conjunctivitis vary between adults and newborns, typically appearing within a few days to a few weeks after exposure. In adults, symptoms emerge 2 to 19 days following infection. These often include redness, eyelid swelling, and a watery or pus-like discharge. Patients may also experience irritation, a scratchy sensation, and increased sensitivity to light. The infection frequently starts in one eye but can spread to both.
For newborns, symptoms of chlamydial conjunctivitis usually manifest 5 to 14 days after birth. Affected infants may exhibit eyelid swelling, eye redness, and a pus-like or watery discharge. If left untreated, it can lead to severe complications, including lung infections and, in some cases, blindness.
Accurate diagnosis is obtained through laboratory tests, as chlamydial conjunctivitis symptoms can resemble other forms of pink eye. A healthcare provider may take a swab of the conjunctiva to test for Chlamydia trachomatis bacteria. Comprehensive testing for other sexually transmitted infections is also recommended, as a genital chlamydia infection often co-occurs in adults with chlamydial conjunctivitis.
Treatment for chlamydial conjunctivitis involves antibiotics. For adults, oral antibiotics like a single dose of 1 gram of azithromycin or 100 milligrams of doxycycline twice daily for one week are commonly prescribed. Erythromycin 500 mg taken four times daily for one week is another option. Since adult chlamydial conjunctivitis is often linked to a genital infection, all sexual partners should also receive treatment to prevent reinfection and further spread.
For newborns, oral or intravenous antibiotics, such as erythromycin for 14 days or azithromycin for 3 days, are necessary. Topical eye drops alone are not effective for newborns because the bacteria can colonize other areas like the nasopharynx.