Chlamydia of the eye: symptoms and treatment of various forms

Chlamydia of the eye is a various lesion of the mucous membrane of the eyes. Experts also call this disease ophthalmochlamydia. Most often, ocular chlamydia is a concomitant disease against the background of the main, urogenital chlamydia.

Both men and women can become infected with this infection, but newborns are also susceptible to this infection. The infection leads to inflammation of the eyes, which, as it spreads, can lead to deterioration of vision, leading to complete blindness.

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General overview

As mentioned above, chlamydia of the eye is an acute or chronic lesion of the mucous membrane of the eye, which is characterized by strong replenishment (conjunctivitis). Microorganisms of chlamydial infection can parasitize various organs for a long time, being dormant and waiting for the time of their active growth. The incubation period for ocular chlamydia lasts approximately 21 days. During this time, parasites can be transmitted from cell to cell during reproduction, infecting all organs and systems, including the eyes.

With chlamydia in the eyes, 6-7 periods of active growth of microorganisms occur during the entire incubation period. It's like a ticking time bomb. If the disease is not detected in time, the consequences can be quite dire, and if vision is completely lost, treatment may be ineffective.

Infection

Dirty hands often cause infection with chlamydial conjunctivitis. In adult men and women, chlamydial conjunctivitis most often develops due to bacteria from the genitals getting into the eyes.
The cause may be dirty hands and the use of hygiene items (scarves, towels, washcloths, etc.). Infection can also occur as a result of orogenital sexual intercourse. Public swimming pools, baths and saunas become frequent places for the spread of chlamydia. This occurs due to insufficient chlorine levels in the water. However, an increased concentration of this substance can cause the development of an allergy to chlorine.

Obstetricians, gynecologists, urologists, andrologists and venereologists are at constant risk - they can get the infection directly from patients. Transmission of infection is also possible in the practice of ophthalmologists.

Transmission routes

Being a contagious disease, chlamydia in the eyes is transmitted in several ways:

Lack of hygiene is the most common way; people themselves transmit microorganisms by rubbing their eyes with dirty hands or using shared personal hygiene products (sources of infection can be a shared towel, underwear or shared utensils; bacteria can also be picked up in the pool or even the subway).
Occupational disease - this is how specialists such as gynecologists, urologists, ophthalmologists can become infected when they carry an infection with their hands while examining a patient. Such an incident can occur if hygiene and safety measures are not followed.
Oral sexual intercourse can also be a way of transmitting the disease. The genitals or purulent discharge from the eyes can be a source of infection.
Microorganisms can be transmitted from animals (cats) to humans - this route of transmission is the least common.
From mother to child during childbirth or during pregnancy, but children can become infected if personal hygiene is not observed.

Chlamydia microorganisms can live on objects in contact with patients for about 24 hours, making household transmission the most common route.

Conjunctivitis occurs 2 times more often in women than in men; adults from 20 to 40 years old and children aged 12-15 years are susceptible to infection with this infection. The source of infection is any sick person and any thing associated with a sick person.

Causes of pathology development and risk factors

The main cause of the disease is the penetration into the eyes of a pathogen transferred from the genitals during intimate intimacy (sexual route of infection), as well as from hands and personal belongings that have become infected with the infected secretions of a sick person (domestic route).

Methods of infection:

Bacteria enter the eyes by transfer from urogenital secretions during intimate proximity, from the mucous and purulent discharge of the eyes of a sick person.
Infection with chlamydia is possible through the common use of towels, napkins, washcloths, toys, dishes and underwear, and by shaking hands.
In women, frequent cases of infection are caused by the spread of the parasite through cosmetics.
Transmission of the pathogen often occurs through water in public pools and baths (pool conjunctivitis). Due to insufficient concentration of chlorine, which is unable to neutralize parasites, outbreaks of mass infection with ophthalmochlamydia occur.
Young children become ill when they accidentally introduce the germ when they rub their eyes after touching contaminated objects.
There have been cases where doctors, including gynecologists, urologists and obstetricians, became infected while examining patients.

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The activation of chlamydia can be triggered by unfavorable factors, including:

acute viral and bacterial infections;
suppressed immunity due to severe and long-term illness or taking immunosuppressants;
overheating and hypothermia of the body;
long-term treatment with antibacterial agents;
a pre-existing autoimmune disease - Reiter's syndrome (the causes and mechanism of development have not been fully studied).

Who is at risk

You are more likely to become infected:

adults and adolescents aged 13–15 years, leading an active sexual life with frequent changes of partners;
patients with urogenital chlamydial infection;
members of a family or close group where a patient with any type of chlamydia is located;
newborns (if the mother is infected);
persons diagnosed with chronic conjunctivitis of any type;
people who often spend time in saunas, baths, and visit swimming pools.

Symptoms of the disease

The incubation period after infection can be 5-14 days, and only then the first signs appear. Usually, at the initial stage, only one eye becomes inflamed; after a while, the infection spreads to the second. Here are the symptoms of chlamydial conjunctivitis that indicate the disease:

hyperemia and severe swelling of the conjunctiva;
increased lacrimation;
severe photophobia, pain when moving the eyeballs;
swollen lymph nodes;
hearing loss.

Chlamydial conjunctivitis of the eyes in adults can be acute, subacute and chronic. The acute form is characterized by copious discharge of pus (this is generally a hallmark of bacterial inflammation of the eyes), swelling of the conjunctiva on both eyelids, and damage to the cornea. The acute stage lasts from 2 weeks to 3 months.

When the disease passes into the chronic stage, the conjunctiva may thicken and large follicles may appear in the lower eyelid. This form of the disease is also characterized by frequent blepharitis.

Symptoms of conjunctivitis that occurs against the background of chlamydia are similar to those of adenoviral infection. However, each type has its own characteristics. Only a specialist will make an accurate diagnosis. This must be done to prescribe the correct therapy.

Symptoms of chlamydia in the eyes

From the moment of infection to the appearance of the first symptoms of infection, it usually takes up to 2 weeks. As a rule, only one eye is affected; bilateral damage is seen in only a small proportion of patients.

More than half of all cases of the disease occur in the form of an acute eye infection, the other part - as a chronic course of the disease.

Symptoms of ocular chlamydia vary, but the most common are:

redness of the eyes - manifests itself at an early stage of the disease. This symptom is common to many eye diseases and is therefore nonspecific;
pain and discomfort in the eye area in the form of burning and stinging;
fear of light - a painful reaction to light occurs individually;
the feeling of a foreign object in the eye means that the infection is localized under the eyelid;
tearing - the protective mechanism of the eye tries to get rid of foreign formations, but tears are powerless against infection;
deterioration of vision - observed at the stage of disease progression and without proper treatment leads to blindness;
cloudiness of the image - the visible image appears unclear and blurry in the eyes;
the presence of follicles is the main sign of ocular chlamydia. The bubbles are located on the inside of the eyelids.

In each patient, chlamydial conjunctivitis occurs differently due to the individual characteristics of the body.

Diagnosis of chlamydial conjunctivitis

To establish the type of disease, the ophthalmologist conducts a complete collection of laboratory tests. If additional examination is necessary in case of suspected chlamydial conjunctivitis, he writes out referrals to other specialized specialists: venereologist, urologist, gynecologist, etc.

Using a slit lamp, characteristic swelling, infiltration, and vascularization of the limbus are revealed. The condition of the uveal tract and retina can be examined by ophthalmoscopy. To make an accurate diagnosis, it is recommended to carry out several methods for detecting chlamydia in scrapings from the conjunctiva.

Prevention

The best measure to prevent the disease is to follow the simplest rules:

regular hand washing;
giving up the habit of touching and rubbing your eyes with your hands, especially in public places;
refusal to use other people's household items, cosmetics;
use of individual or disposable tableware, hygiene items, medical supplies;
strengthening the immune system.

Prevention of chlamydial conjunctivitis requires timely identification and treatment of urogenital chlamydia, eye protection with goggles when swimming in the pool, and compliance with safety precautions by medical personnel.

Treatment of the disease

Treatment of chlamydia is carried out comprehensively, individually, taking into account the duration of infection, localization of the process, and the presence of complications. It is important to understand that for genitourinary chlamydia, all sexual partners must undergo mandatory examination and treatment, preferably at the same time, to avoid repeated infections. If chlamydia is not detected in one of the partners after a full examination, then preventive treatment is recommended if sexual intercourse has been ongoing for a month before the test.

Antimicrobial therapy

Chlamydia is a pathogenic bacterium, so chlamydia requires the mandatory prescription of antibiotics. Chlamydia is sensitive to therapy with tetracyclines, macrolides and fluoroquinolones. Treatment of children and pregnant women is permissible with antibacterial drugs from the macrolide group.

The duration of antibacterial therapy depends on the presence of complications of infection (orchiepididymitis, prostatitis, salpingo-oophoritis) and the duration of infection. For fresh, uncomplicated chlamydia, the duration of antibiotic use is usually 7–10 days. In complicated forms of the disease, specific arthritis (Reiter's disease), the duration of antibacterial therapy can be up to 28 days with the sequential use of two antibiotics.

The causative agents of chlamydia, like other bacterial infections, are capable of developing resistance to antibiotics. The number of resistant strains of chlamydia is growing, so if the infection is repeated, similar therapy may not be effective.

Important! Immune drugs are not the basic means in the treatment of chlamydia. They are not included in modern clinical protocols for chlamydial infections.

Treatment at home and in hospitals

In most cases of uncomplicated chlamydia, therapy is carried out with outpatient tablets.

Complications such as inflammatory diseases of the uterus and appendages, orchiepididymitis, chlamydial pneumonia and infections in newborns require treatment in specialized hospitals. In these cases, intensive treatment with injectable forms of drugs is used, and physiotherapy is used.

Sometimes pathogenetic and symptomatic approaches to treatment are used. This is due to the fact that chlamydia is an intracellular microorganism. As a result of inflammation, they are capable of causing scarring and adhesions in the pelvic organs. Chlamydial arthritis occurs with severe pain in the joints. Therefore, in such cases, proteolytic enzymes, anti-inflammatory and painkillers are prescribed.

Important! After treatment for chlamydia, it is important to conduct a follow-up examination of the patient and partners using the PCR method. In this case, it is recommended to monitor therapy no earlier than a month after completion of antibacterial drugs. If the patient has no complaints or clinical manifestations of the disease, and the test results are negative, this confirms the patient’s recovery.

How to treat chlamydial eye disease

The peculiarity of chlamydia is that it is difficult to treat, since not all antibacterial drugs are able to destroy the pathogen. As a result of incorrectly prescribed therapy, infected patients receive a long-term, indolent eye infection, in which microorganisms, along with the bloodstream, easily penetrate into other organs.

It is prohibited to self-prescribe medications. Self-medication can “mask” the true signs of pathology, worsen the condition and contribute to the development of a chronic form of the disease.

The main principle of therapy is a combination treatment prescribed by a dermatologist or dermatovenerologist, ophthalmologist, gynecologist and urologist.

To achieve the desired result, it is important:

Confirm the type of pathogen.
Determine the sensitivity of the parasite to specific antibiotics (especially if the patient has previously received antimicrobial agents), since bacteria are capable of developing immunity to them.
Select a specific antimicrobial drug taking into account the severity of the disease, the patient’s age, concomitant pathologies, primary and recurrent (relapse) of the disease (only a doctor can do this).

Drug therapy

As already mentioned, eye diseases caused by chlamydia are usually associated with urogenital chlamydia, have a protracted course with a tendency to exacerbations and re-infections, and are accompanied by numerous complications, so therapy for this pathology is difficult.

The main medications that a doctor prescribes to a patient are:

Antibiotics in tablet form. Of these, macrolides, fluoroquinols and tetracyclines, which have pronounced activity against chlamydia, are most often used. The results obtained in practice confirm the high effectiveness of the following drugs in the complex treatment of ophthalmochlamydia: Ciprolet, Xenaquin (Lomefloxacin), Sumamed (Azithromycin, Zitrolide).
Antibiotics in the form of drops. They are used to destroy pathogens in the tissues of the eye. The following drugs are widely used: Picloxidine, Okacin, Vitabact, Colbiotsin, Tsipromed, Floxal.
Antibiotics in ointment form. They also help kill germs in the eye. Tetracycline, erythromycin ointments, Ofloxacin and Floxal are successfully used.

It should be borne in mind that Colbiocin and Vitabact often cause eye irritation and allergic reactions. In these cases, the medicine is discontinued by prescribing Cromohexal or Lecrolin. According to observations, patients tolerate Tsipromed and Okacin best, which are very effective against chlamydia.

With regard to antimicrobial therapy, the treatment regimen included the use of Erythromycin or Tetracycline in combination with Doxycycline. However, recently, experts have been trying not to prescribe Tetracycline due to multiple side effects and the development of a high degree of resistance in bacteria to it.

Before starting antibacterial treatment, patients with a confirmed diagnosis of chlamydial conjunctivitis (and their sexual partners) are recommended to be screened for other sexually transmitted diseases, including syphilis and gonorrhea.

Both eyes should be treated with topical medications, even if only one is affected by the infection.

Medicines used in treatment are shown in the photo

Local treatment with Sumamed is effective when taking the same antibiotic orally

Lefloxacin - popular eye drops for trachoma

Antimicrobial drops Tsipromed are often used in the treatment of chlamydial conjunctivitis

Vitabact is one of the safest remedies for the treatment of bacterial conjunctivitis

Okacin is highly effective against chlamydial eye infections

Floxal - local remedy for eye installations

Erythromycin ointment is used topically for chlamydia of the eye

Azithromycin is an active antibiotic against chlamydia

Additionally, the doctor prescribes:

For corneal lesions - eye gel Solcoseryl, Actovegin.
When tear secretion is suppressed - Oftagel, Vidisik.
In case of persistent progression and active development of follicular manifestations, physiotherapeutic laser treatment is recommended.
In case of severe swelling and severe irritation of the conjunctiva, installation of antiallergic drops is used: in the acute period, Allergoftal, Olopatadine, Spersallerg (Antazoline and Tetrizoline), Ditadrin (Diphenhydramine and Naphazoline) are used, in the chronic period - Alomil and Lecrolin.
Orally - antihistamines (Desloratadine, Zodak, Suprastin, Tavegil).
On the 7th–8th day of treatment for severe inflammation and swelling - hormonal eye drops Dexapos (Dexamethasone), Maxidex in a short course.

Folk remedies

Treatment of conjunctivitis is entirely related to the cause, and herbal medicine can only be used as an addition to the main medications prescribed by a doctor, as a means to reduce inflammation and swelling. But natural substances that are used in folk medicine do not have the strong antibacterial activity necessary to destroy chlamydia.

If the diagnosis of chlamydial infection has not yet been confirmed, and the eye pathology is caused by gonococcal infection or Pseudomonas aeruginosa, drug treatment should be started immediately, rather than trying to use traditional medicine recipes, since a delay of even a day can lead to loss of the eye.

Experts recommend using herbs and natural substances for topical use very carefully and advise you to consult an ophthalmologist before doing so, since folk remedies can reduce the effect of basic medications and provoke severe allergic reactions.

Of the homemade healing “potions”, it is advisable to use only those that are intended for oral use and have general antimicrobial, anti-inflammatory and immune system-strengthening properties.

Forbidden:

apply bandages, since such “treatment” increases the risk of corneal inflammation;
make warm compresses that create a “greenhouse effect”, especially favorable for the activation of microorganisms;
rinse your eyes with tea leaves, since tannins tighten the pores along the edges of the eyelids, “sealing” the remains of purulent discharge;
instill urine into the eyes (risk of damage to the cornea);
wash with tap water, as it will increase inflammation.

Some home recipes:

Take chamomile, marshmallow and eyebright in equal quantities. Pour a tablespoon of dry collection into 250 ml of boiling water and keep on low heat for 10 minutes. Gently rinse your eyes with a warm decoction every hour until the inflammation goes away.
Mix the juice of endive lettuce (1 part), carrots (4 parts), celery, parsley, 1 part each and take 3 times a day, half a glass before meals.
Mix hop cones and blueberry (or blueberry) leaves in a 1:1 ratio. Pour a tablespoon of the mixture into 250 ml of boiling water and leave for 60–90 minutes. Drink 50 ml half an hour before meals 4 times a day.
Dill juice has been successfully used for eye irritation. A soft cotton cloth is soaked in fresh dill juice and then applied to the eyelids for 30–40 minutes.
Finely grate raw potatoes, mix eggs with whites, squeeze a little and apply on eyelids. Place a cloth soaked in hot water on the back of your neck.
If you are not allergic to honey, dilute it with warm boiled water in a ratio of 1:2 and use it as a lotion.

Medicinal herbs and natural products for eye chlamydia - photo gallery

Hop cones are used in eye wash mixtures

Honey dissolved in water is a good bactericidal agent.

Marshmallow is good to use in decoctions for ophthalmochlamydia

Blueberry leaf is used in antiseptic preparations

Carrot juice has a healing effect on sore eyes

Diluted dill juice will help with chlamydia of the eyes

Chamomile relieves inflammation and disinfects

Nutrition

Is a special diet needed when treating chlamydia? As a rule, no. They recommend a diet that contains a balanced and sufficient amount of vitamins, minerals, proteins, fats and carbohydrates.

To reduce the toxic effect of antibiotics on the liver, it is not recommended to take fatty, smoked, fried foods, carbonated drinks, sauces, ketchups and mayonnaise. Drinking alcohol is prohibited.

The daily calorie content of food should be 2000–2500 kcal. It is preferable to eat small portions 5-6 times a day. The volume of liquid consumed is 1.5 liters per day, preferably in even portions, preferably before 6 pm.

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Interesting to know:

Bibliography

Centers for Disease Control and Prevention. Brucellosis. Parasites. Link
Corbel MJ Parasitic diseases // World Health Organization. Link
Young EJ Best matches for intestinal parasites // Clinical Infectious Diseases. — 1995. Vol. 21. - P. 283-290. Link
Yushchuk N.D., Vengerov Yu.A. Infectious diseases: textbook. — 2nd edition. - M.: Medicine, 2003. - 544 p.
Prevalence of parasitic diseases among the population, 2009 / Kokolova L. M., Reshetnikov A. D., Platonov T. A., Verkhovtseva L. A.
Helminths of domestic carnivores of the Voronezh region, 2011 / Nikulin P. I., Romashov B. V.

An article for patients with a doctor-diagnosed disease. Does not replace a doctor's appointment and cannot be used for self-diagnosis.

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