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.
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
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
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.
10.
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
20. Lid signs.
*sequelae in the lids may be.
-trichiasis
-entropion
-tylosis
-ptosis
-madarosis
-ankyloblepharon
lacrimal apparatus sequelae
*chronic dacryocystitis
*chronic dacryoadenitis
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.