Are your eyes sore? Redness and itching? Perhaps this is a manifestation of chlamydial conjunctivitis, a dangerous disease that occurs in about 3 out of 10 cases of conjunctivitis. To quickly and effectively overcome the disease, treatment should be taken now.
Basic concepts
Chlamydial conjunctivitis is an inflammatory disease of the ophthalmic conjunctiva caused by the chlamydia bacterium. Quite often, this disease is called somewhat differently: chlamydia and ophthalmochlamidiosis, but the essence does not change from this.
The vast majority of patients with this diagnosis belong to the age category of 25-45 years, while the number of cases of illness in men is much higher. Ophthalmochlamidiosis may occur in childhood.
Causative agent of the disease
The main reason chlamydial conjunctivitis occurs is when chlamydia (Chlamydia trachomatis) enters the body and this bacteria damages the mucous membranes of the eye. Chlamydia trachomatis is only one of the varieties of the chlamydia genus. Its feature is the defeat only of the human body.
Despite the fact that it also occurs in animals, this mode of existence is considered temporary for her. In other words, animals act as an intermediate host. An important feature of chlamydial conjunctivitis is the background nature of the disease. This concept means that conjunctivitis of this type most often occurs against the background of a general infection with chlamydia.
A distinctive feature of such a bacterium is increased survivability and the ability to be in the incubation period for a long time. So, when Chlamydia trachomatis enters the human body, it does not always lead to an immediate manifestation of the disease. Often a person for a long time does not suspect an illness. Active reproduction of bacteria and the appearance of characteristic symptoms of chlamydial conjunctivitis can occur with certain factors.
What can cause chlamydia in the eyes?
Chlamydia infection may have a delayed effect. So, if the human immunity is at the proper level, the active reproduction of chlamydia is blocked and they are in a sleeping state or completely destroyed. These or other negative changes in the body for internal or external reasons immediately trigger the mechanism of the development of the disease.
Doctors indicate several factors that can trigger the onset of symptoms:
- long-term use of antibiotics (quite often this happens with self-administration of potent drugs);
- severe hypothermia of the body;
- heatwave;
- the presence of immunodeficiency of any type;
- recent diseases (including acute respiratory viral infections).
Infection pathways
The infection of a healthy person with the bacterium Chlamydia trachomatis occurs in several ways.
- Sexual. As already noted, chlamydial conjunctivitis of the eye rarely acts as an independent disease. More often, this is an infection that has got on the mucous membrane of the eye from the genital tract. Chlamydia can be infected with unprotected sex.
- Domestic. Chlamydia infection in everyday life is also possible. Most often this happens with close contact or in a public place (for example, in a bathhouse, pool).
- Occupational hazard. Such a disease is often affected by health workers conducting examinations or treatment of patients with chlamydia.
Conjunctivitis in newborns
Chlamydial conjunctivitis in children (newborns) is not as rare as it may seem at first. According to medical statistics, such a diagnosis is observed in 5-10% of newborns.
Chlamydia infection can occur in this case for 2 reasons:
- mother’s disease during pregnancy - in this case, chlamydia crosses the placenta and affects the baby’s body;
- during childbirth - passing through the birth canal, the baby can easily become infected if the woman is an infected person.
The danger of chlamydia for a child consists not only in infection with bacteria, but also in serious consequences. Along with eye damage, there is a chlamydial infection of other organs and systems:
- respiratory apparatus (chlamydial pneumonia);
- nasolacrimal duct (eustachitis, rhinitis, nasopharyngitis, acute otitis media and many other lesions).
Forms of the disease
In medicine, it is customary to divide ophthalmochlamidiosis into several types. The difference mainly lies in the localization of the inflammatory process. It stands out:
- paratrachoma;
- trachoma;
- chlamydial uveitis (the choroid of the eyes becomes inflamed);
- pool conjunctivitis;
- chlamydial episcleritis (this term refers to the inflammatory disease of the episclera, the tissue that is located between the sclera and conjunctiva);
- conjunctivitis accompanied by Reiter's syndrome;
- chlamydial meibolitis (such a diagnosis is made with inflammation of the meibolinic glands of the eye).
Course of the disease
As for the form of the course of conjunctivitis, it can be acute, subacute and chronic.
The acute form is the most common manifestation of the disease. It is characterized by rapid development and pronounced symptoms of chlamydial conjunctivitis. The photo shows the characteristic state of the eyes in this course. It should be noted that this form has a good susceptibility to drugs. In other words, timely access to the clinic and properly prescribed therapy give a quick lasting result.
The subacute form is characterized by symptoms of medium brightness and can often be mistaken for other ophthalmic diseases with similar manifestations.
Chronic form. This type of disease is most dangerous, as it has mild manifestations and symptoms. However, chronic ophthalmochlamidiosis is prone to frequent exacerbations and relapses. Treatment in this case requires a longer and more complex.
Symptoms of chlamydial conjunctivitis
Immediately after infection, the disease may not manifest in any way - this period is called incubation. It lasts about 7-14 days. At the end of this time, the disease becomes acute.
It is noted that in most cases, one eye is first affected (only the right or left) and only then the infection spreads to the second eye. This happens mainly for the reason that a person carries bacteria during scratching or rubbing his eyes. Both eyes immediately become inflamed in about 30% of cases.
There are no characteristic signs of chlamydia in the eyes, most of the symptoms are found in other inflammatory diseases.
Symptoms
- Swelling of the mucous membrane of the eye, transitional folds, eyelids. The degree of manifestation of this symptom depends entirely on the form of the course. In the photo above - chlamydial conjunctivitis is of acute form.
- Lacrimation. In some patients, the secretion of tears is characterized as small, while in others, there is profuse tearing. This largely depends on the localization of the inflammatory process.
- Itching and cramping, sensation of sand in the eyes.
- Mucopurulent discharge from the conjunctival sac. They can be scarce or, on the contrary, plentiful.
- At times, patients complain of tinnitus, a sharp decrease in hearing quality, and headaches. Such signs may indicate that the inflammatory process has already passed to the hearing organs. In this case, complications such as inflammation of the auditory tube (eustachitis) are possible.
Diagnostics
The doctor should be consulted as soon as the first symptoms appear. Treatment of chlamydial conjunctivitis at home often not only does not help in the fight against the disease, but also enhances the symptoms. The reason is the wrong selection of medicines (chlamydia is resistant to certain drugs prescribed for other types of conjunctivitis).
It is for this reason that an examination is necessary.
Primary reception. At the first examination, the doctor’s task is to identify the clinical picture. To do this, it is very important to listen to the patient’s complaints and note the degree of swelling of the eyes, the presence or absence of purulent discharge, the condition of the mucous membrane of the eyes.
A sample taken from the mucous membrane of the eye. Scraping is performed under local anesthesia, so the patient does not feel pain or discomfort. This sample is sent to a laboratory for histological examination. Based on the diagnostic results, the presence or absence of chlamydia will be detected. This test is the fastest, but not always accurate.
Direct immunofluorescence. During this test, samples obtained as a result of scraping are stained with specific antibodies (they are common for chlamydia). Compared with the previous diagnostic method, direct immunofluorescence is more effective and accurate.
Polymerase chain reaction method (often referred to as PCR or DNA diagnostics). When studying scraping, a site is identified that has a DNA sequence characteristic of chlamydia.
The cultural method. At this time, this method is considered the reference, as with 100% accuracy reveals the presence of chlamydia. The cultural method consists in the cultivation of pathogen cells in laboratory conditions. The only drawback is the length of the laboratory process (48-52 hours).
How to treat chlamydial conjunctivitis?
The main method of treatment is medication with the use of antibiotics. In this case, the doctor takes into account the following features.
Chlamydia are intracellular parasites, and therefore have a sensitivity to antibiotics of etiotropic action.
Another important factor is the form of the disease. So, chronic chlamydial conjunctivitis has probably already been treated, so the bacteria managed to develop immunity to previously used drugs. For this reason, during laboratory methods, the sensitivity of chlamydia is detected.
According to the form of medicines, the doctor can prescribe medications for:
- topical application (these include eye drops, cream, gel or ointment);
- general (most often these are tablets and capsules).
The following groups of antibiotics have an etiotropic effect:
- tetracyclines;
- fluoroquinolones;
- macrolides.
Often, antihistamines are added to antibiotics.
The duration of treatment is chosen by the doctor, but on average the course lasts 21 days. This period is important to consider in order to affect all cycles of chlamydia.
How is treatment chosen?
As for the selection of a specific tool, the following factors are taken into account:
- patient age;
- the form and stage of development of the disease;
- the presence of concomitant diseases;
- pregnancy and lactation.
It should be noted that when identifying the chlamydial nature of the disease, in addition to the ophthalmologist, you will have to visit other narrow specialists:
- venereologist;
- gynecologist;
- urologist;
- laura (with complications).
Treatment prognosis
Given the right treatment, chlamydial conjunctivitis is eliminated quite effectively. An important requirement in this case is the strict observance of medical recommendations. Many patients interrupt the course of drug therapy immediately after the symptoms are resolved. It is strictly forbidden to do this, since in this case not all bacteria are eliminated and the disease becomes chronic. To cope with an illness of this form will be much more difficult.
To reduce the risk of re-infection during washing, the patient should always use a clean towel. In addition, the patient must be careful and use certain personal items.
Prevention
There are some ways to prevent chlamydia.
- Use only personal items, each member of the family should have their own towel and other personal hygiene items.
- When visiting the pool, saunas, it is best to have special glasses that protect the eyes from the penetration of chlamydia and many other bacteria and viruses.
- Monitor the state of immunity. In a healthy person, the immune system quickly eliminates the causative agents of diseases that enter the body. So, for prevention, proper nutrition, regular walks in the fresh air, physical activity, and giving up bad habits are very important.
- In order to avoid chlamydia in newborns, a woman should pay special attention to pregnancy planning and undergo regular diagnosis.
Doctors emphasize: this disease has a serious danger and unpleasant (judging by the complaints and photos) symptoms. Treatment of chlamydial conjunctivitis at the same time gives good effectiveness. The most important thing is not to delay the appeal to the clinic and strictly follow the doctor’s recommendations.