What is Chlamydial Conjunctivitis?
Chlamydial conjunctivitis is an infection of the conjunctiva, the transparent tissue layer that lines the inner surface of the eyelids and covers the white of the eye. This specific variant of “pink eye” is caused exclusively by certain strains of the bacterium Chlamydia trachomatis, the same organism responsible for the common sexually transmitted infection.
The condition’s presentation is often distinct from other forms of conjunctivitis. It typically produces a significant mucopurulent discharge—a thick, sticky combination of mucus and pus—along with pronounced redness and swelling of the eyelids. The illness manifests in two main forms: inclusion conjunctivitis in sexually active adults, which can become a chronic, lingering problem if untreated, and neonatal conjunctivitis, which is an acute infection acquired by infants during birth that affects both eyes.
Causes:- Autoinoculation in Adults: In sexually active individuals, this is the predominant cause. The infection occurs when a person inadvertently transfers infectious genital fluids to their eyes, typically via their hands. This self-transmission can happen easily, especially since the underlying genital chlamydial infection often produces no symptoms and the individual may be unaware they have it.
- Perinatal Transmission to Newborns: Infants acquire the infection during vaginal birth. If the mother has an untreated chlamydial infection in her cervix, the baby is directly exposed to the bacteria while passing through the birth canal. This exposure leads to the development of neonatal conjunctivitis, usually within the first two weeks of life.
- Sexually Active Young Adults: The primary risk group comprises sexually active individuals, particularly those under the age of 25. The probability of infection increases significantly for people who do not consistently use barrier methods like condoms or who have new or multiple sexual partners, as these behaviors raise the likelihood of acquiring the genital infection that precedes eye involvement.
- Newborns of Infected Mothers: Infants delivered vaginally by mothers with an active, untreated chlamydial infection face a very high risk. During the birthing process, the newborn comes into direct contact with the infectious bacteria in the birth canal, leading to the development of neonatal conjunctivitis.
- Partners of Infected Individuals: The sexual partners of people who have a chlamydial infection are also at substantial risk. Because the genital infection is frequently asymptomatic, it can be unknowingly transmitted, creating a new host who is then vulnerable to the autoinoculation that causes the eye infection.
