Ocular chlamydia refers to an infection of the eye caused by the bacterium Chlamydia trachomatis. This condition, also known as inclusion conjunctivitis in adults or ophthalmia neonatorum in newborns, can lead to inflammation of the conjunctiva, the clear membrane covering the white part of the eye and lining the inside of the eyelids. While often associated with genital infections, Chlamydia trachomatis can affect various parts of the body, including the eyes.
Visual Symptoms and Other Signs
Chlamydia in the eye can manifest with several noticeable symptoms, often resembling other forms of conjunctivitis. The affected eye, which can be one or both, appears red and may feel itchy, swollen, or scratchy. A discharge is present, ranging from watery to a thick, sticky, purulent (pus-like) consistency, which can cause eyelids to crust or stick together, particularly upon waking.
Individuals may also experience increased tearing and sensitivity to light, a condition known as photophobia. Discomfort can include a burning sensation or the feeling of a foreign body or “grit” in the eye. Lymph nodes located in front of the ears may become enlarged. While vision remains unaffected in adult cases, symptoms can persist for weeks to months, making it challenging to differentiate from other eye infections without medical assessment.
How Ocular Chlamydia Develops
Ocular chlamydia primarily develops when the Chlamydia trachomatis bacterium comes into direct contact with the eye. The most common route for adults is through hand-to-eye contact after touching infected genital secretions, a process known as autoinoculation. This means if a person has a genital chlamydia infection and then touches their eyes without proper hand hygiene, the bacteria can be transferred.
Newborns can acquire ocular chlamydia, specifically ophthalmia neonatorum, during vaginal childbirth if the mother has an untreated chlamydial infection. Less common transmission methods can include sharing contaminated items like towels, washcloths, or eye makeup.
Seeking Diagnosis and Treatment
Prompt medical attention is advised if ocular chlamydia is suspected, especially since it often mimics other eye infections and will not resolve on its own. A healthcare provider will perform an eye examination and inquire about the patient’s medical history and recent activities, including sexual contact. To confirm the diagnosis, a swab of the eye may be taken and sent to a laboratory for testing, often using polymerase chain reaction (PCR) or nucleic acid amplification testing (NAAT) to detect the specific bacterial DNA or RNA.
Treatment for ocular chlamydia involves oral antibiotics, as topical eye drops alone are insufficient due to the potential for systemic infection. Common oral antibiotics prescribed include a single 1-gram dose of azithromycin or 100 milligrams of doxycycline taken twice daily for one week. Erythromycin, 500 milligrams four times daily for one week, is another option. It is also recommended that all sexual partners of the infected individual be evaluated and treated to prevent reinfection and further spread.
Potential Complications and Prevention Strategies
If left untreated, ocular chlamydia can lead to significant complications, particularly chronic conjunctivitis. In severe cases, it can progress to trachoma, a condition that causes scarring of the inner eyelid. This scarring can cause the eyelashes to turn inward, rubbing against the cornea and potentially leading to corneal ulcers, further scarring, vision impairment, and even permanent blindness. Newborns with untreated ocular chlamydia may also develop lung infections.
Prevention strategies for ocular chlamydia center on reducing exposure to the bacterium. Practicing good hand hygiene, particularly avoiding touching the eyes after contact with genital areas, is a simple yet effective measure. Using barrier protection during sexual activity helps prevent genital chlamydia, thereby reducing the risk of ocular transmission. For pregnant individuals, routine screening and treatment for chlamydia before childbirth are recommended to prevent transmission to the newborn.