Clinical features

In infants, infection is usually apparent 3 to 13 days post partum, often after the baby has been discharged. There is conjunctival hyperaemia, oedema and a purulent exudate. If hyperacute, there may be pseudomembranes which can result in scarring. There is no follicle formation since the newborn lacks adenoid tissue in the conjunctival stroma. However, follicles may appear if the condition persists for several months.

Papillae and follicles, especially on the lower conjunctival tarsus are characteristic of infection in adults. Presentation may be with unilateral or bilateral asymmetric conjunctivitis associated with moderate hyperaemia and mucopurulent discharge (1). Oedema, eye irritation, foreign body sensation, and an enlarged preauricular lymph node may also be seen (2)

Occasionally, there is a superficial keratitis. Scarring is rare since pseudomembranes do not form.

Reference:

• (1) Drummond SR, Diaper CJ. Chlamydial conjunctivitis presenting as pre septal cellulites. Head Face Med. 2007;3:16
• (2) Abelson MB, Leung S. The Many Faces of Chlamydial Infection The two ocular infections caused by C.trachomatis and how we can combat them. Rev Ophth 2008;15:04