Chlamydial conjunctivitis - Causes, Symptoms, Diagnosis and Treatment
Chlamydial conjunctivitis - Infection of the mucous membrane of the eye chlamydia, accompanied by acute or chronic inflammation of the conjunctiva. Chlamydial conjunctivitis occurs with swelling of the conjunctiva and transient folds, purulent discharge from the eyes, watery eyes, sharp pain in the eyes, follicular rash on the lower eyelid, the parotid adenopathy, evstahiita phenomena. Diagnosis of chlamydial conjunctivitis is to conduct biomicroscopy, cytology, culture, enzyme immunoassay, immunofluorescence, PCR studies for determination of chlamydia. Treatment of chlamydial conjunctivitis is performed using antibiotics tetracycline, macrolides and fluoroquinolones to complete clinical and laboratory recovery.
Chlamydial conjunctivitis
conjunctivitis of different etiologies. Chlamydia eye is more common in people aged 20-30 years, while women get chlamydial conjunctivitis in 2 - 3 times more often than men. Chlamydial conjunctivitis occurs mainly on the background of urogenital chlamydia (urethritis, vaginitis cervicitis), which can occur in the form of a worn and do not disturb the patient. Therefore, chlamydial infections are included in the scope of attention of ophthalmology, Venereology, Urology, Gynecology.
SARS, overheating), during the period of immunosuppression, there is "awakening" (reversion) of chlamydia from L-forms and active reproduction with the development of clinical symptoms.
Various serotypes of Chlamydia antigen induce various lesions: for example, serotypes A, B, Ba, and C cause trachoma development; serotype D - K - to the emergence of adult paratrahomy, epidemic chlamydial conjunctivitis, urogenital chlamydiosis; serotypes L1-L3 - to develop chlamydia.
In most cases, chlamydial conjunctivitis occurs against a background of chlamydia urogenital tract: according to statistics, about 50% of patients with urogenital oftalmohlamidiozom also have a form of infection. In adults, ocular Chlamydia is caused by introduction of the agent into the conjunctival sac with a genitals secretions through contaminated hands and hygiene items. At the same time the carrier of urogenital chlamydia can infect not only your eyesight but also your eyes healthy partner. Often chlamydial conjunctivitis is the result of oral-genital sex with an infected partner.
There are cases of occupational exposure chlamydial conjunctivitis among obstetricians, venereologists, urology and andrology, ophthalmologists are examined patients with various forms of chlamydia. Infection with chlamydial conjunctivitis possible through the water when visiting public swimming pools and baths. This form of the disease called "basin" or "bath" and conjunctivitis can often take on the character of epidemic outbreaks.
Chlamydial conjunctivitis can accompany for autoimmune disease - Reiter's syndrome, but the pathogenesis of this pathology oftalmohlamidioza is not fully understood.
Chlamydial conjunctivitis in the newborn may develop as a result of intrauterine (transplacental) infection or eye infection during the birth of a sick mother with chlamydia. Chlamydia eye infection occurs in 5-10% of newborns.
Thus, an increased risk of chlamydial conjunctivitis are sexually active men and women; patients with urogenital chlamydiosis; family members (including children), where there are patients sexually or ocular chlamydial infection; medical professionals; persons attending the public baths, saunas, swimming pools; children born to mothers suffering from chlamydia.
ophthalmia)
In addition, in ophthalmology and other forms of release oftalmohlamidioza: chlamydial keratitis, chlamydial uveitis, episcleritis and other chlamydial
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blepharitis or conjunctivitis with moderate symptoms: slight swelling of the eyelids and hyperemia of the conjunctiva tissue, mucous discharge from the eyes.
Acute chlamydial conjunctivitis and exacerbation of chronic forms accompanied by severe swelling and infiltration of the eyes and transitional folds, photophobia, and lacrimation, rezyu eyes, plentiful department gluing eyelids mucopurulent or purulent secretions from the eyes. Pathognomonic development on the affected side painless regional prootic adenopathy and evstaheita characterized by pain and noise in the ear, hearing loss.
Visual inspection of the eye the conjunctiva defined multiple follicles, soft fibrinous films that usually resolve without scarring. The acute phase of chlamydial conjunctivitis lasts from 2 weeks to 3 months.
In infants and young children, in addition to a pronounced glaznoy symptoms often develop chlamydial pneumonia, nasopharyngitis, rhinitis, acute otitis media, evstahiit. Frequent complications in the form of stenosis nasolacrimal tract, conjunctival scarring.
Eye involvement with Reiter's syndrome can occur in the form of chlamydial conjunctivitis, keratitis, iridocyclitis, horioidita, retinitis.
rheumatologist, an otolaryngologist).
Biomicroscopy eye using a slit lamp reveals a characteristic swelling, infiltration and vascularization of the limb. To eliminate corneal lesions performed instillyatsionnaya Fluorescein test. In order to assess the state of the retina and uveal tract using ophthalmoscopy.
The leading role in confirming the diagnosis of chlamydial conjunctivitis belongs laboratory studies. The best is a combination of different allocation methods for chlamydia in the scrapings from the conjunctiva (cytology, immunofluorescence, culture, PCR) and antibodies in the blood (IFA). If necessary, patients assigned survey on urogenital chlamydiosis.
Chlamydia eye must be differentiated from bacterial and adenoviral conjunctivitis.
instillation of antibiotic eye drops (pp ofloxacin, ciprofloxacin pp) ointment applikatsii for eyelids (tetracycline ointment, ointment eritromitsinovaya), anti-inflammatory drops (pp indomethacin, pp dexamethasone).
Systemic treatment of chlamydia by the scheme of STI treatment. The criteria for cure of chlamydial conjunctivitis are: regression of clinical symptoms, negative data of laboratory tests carried out 2-4 weeks after the end of treatment and three subsequent samples taken at intervals of one month.
Prediction and prevention of chlamydial conjunctivitis
The consequences of suffering a chlamydial conjunctivitis may be different. When rational therapy disease usually ends in complete recovery. Often chlamydial conjunctivitis gets relapsing course.
Exodus relapsing forms oftalmohlamidioza may be scarring of the conjunctiva and cornea, leading to loss of vision.
Prevention of chlamydial conjunctivitis requires timely detection and treatment of urogenital chlamydiosis in adult (in Vol. H. Of pregnancy), the use of personal care products in the family, the protection of the eye glasses while swimming in the pool, use of the protection of medical personnel.