Inclusion Conjunctivitis

Adult inclusion conjunctivitis involving the superior and inferior tarsal conjunctiva. 

  • Most common manifestation of ocular chlamydial infection in sexually active young adults.

Clinical features: 

    • Symptoms: acute or subacute in onset and include ocular irritation, foreign body sensation, watering, mucopurulent discharge and sticking of the lids
    • Signs:
      • Often appears as unilateral disease
      • Usually presents with red eye, swollen lids or chemosis
      • May have palpable uni- or bilateral pre-auricular nodes
      • Follicles tend to occur in the inferior fornix (predilection area), however a mixed follicular and papillary response may also develops in the superior tarsal conjunctiva
      • Corneal involvement:
        • Subepithelial infiltrates
        • Mild superficial keratitis
  • History of sexual activity and previous sexually transmitted disease is important
  • May be complicated with corneal neovascularization and/or conjunctival scaring
  • Conjunctival follicles or corneal infiltrates may persist for months

Management:

  • Combined topical and systemic antibiotics are necessary
  • Systemic antibiotics include doxycycline or tetracycline (contraindicated in pregnant women) or azythromycin in adult patients
  • Sexual contact should also be treated with full course of therapy
  • Signs and symptoms usually improve over 2-4 weeks