Chlamydia found in eyes? Treatment is urgently needed!

Main symptoms:

• Discharge of mucus from the eyes
• Pus in the eyes
• Itchy eyes
• Formation of follicles on the mucous membrane of the eyes
• Swelling of the eyes
• Swelling of the eyelids
• Redness of the eyes
• The appearance of a film on the mucous membrane of the eyes
• Stinging in the eyes
• Tearing
• Noise in ears

Chlamydial conjunctivitis is an infection of the eye mucosa with chlamydia, which is accompanied by inflammation of the conjunctiva. As this disease progresses, the transitional folds and conjunctiva become swollen and inflamed, and purulent exudate oozes from the eyes. One of the most characteristic symptoms of the disease is the appearance of rashes localized on the lower eyelid.

• Pathogen
• Methods of infection
• Classification
• Symptoms
• Diagnostics
• Treatment
• Complications

Chlamydial conjunctivitis in the medical literature is also called ocular chlamydia or ophthalmochlamydia. This type of disease accounts for about 3–30% of the total number of conjunctivitis of various etiologies. Most often it affects people aged 20 to 30 years. This is due to the fact that it is during this period that the most active sexual life occurs. It is worth noting the fact that women become infected with chlamydial conjunctivitis more often than the stronger sex.

Chlamydial conjunctivitis usually begins to progress against the background of existing urogenital chlamydia.

General information about ocular chlamydia

Eyes affected by chlamydia
Chlamydia are microorganisms that combine the properties of viruses and bacteria . They can parasitize epithelial cells for a long time, being in a “dormant” state.

Columnar epithelial cells are found on many mucous membranes, including the eyes. When the immune system is weakened or under severe stress, microorganisms awaken and grow rapidly.

Often eye damage is a concomitant complication of an existing infection in the body. If the organs of vision are damaged, manifestations from the genitourinary system may be completely absent. Infection can occur in an adult, regardless of gender. Newborns and older children are sometimes infected.

When chlamydia enters the eye, the microorganisms go through 7 growth stages over the entire incubation period.

Life cycle of chlamydia

During its development, chlamydia spends most of its time inside the host cells (the bacterium is capable of reproducing only in the epithelium) and can establish long-term connections with the cells of the human urinary and reproductive systems. Bacteria of the genus Chlamydia do not synthesize ATP (molecules containing energy reserves to ensure the life of the bacterium), therefore the biological cycle of bacteria is limited to the boundaries of the affected cell.

A decrease in the level of nutrients and microelements (amino acids, iron, vitamins) negatively affects bacteria, leading to a decrease in metabolic processes, stopping the reproduction and infection of new cells.

It is precisely because of the peculiar cycle of development and reproduction that chlamydia stands apart from other bacteria. The species of bacteria within the genus Chlamydia differ somewhat (differentiation is carried out by examining inclusions in the affected epithelial cells).

In their development cycle, bacteria of the genus Chlamydia go through two stages: elementary bodies (EB) and reticular bodies (RT). ETs are optimized for survival in the external environment, outside the host cells, while RTs are responsible for reproduction in the epithelium.

Figure 2 – Cycle of development and reproduction of chlamydia

The biological cycle can be divided into the following stages:

1. 1Attachment of an infectious particle, ET, to the epithelium;
2. 2Phagocytosis of particles, capture of ET cells;
3. 3Morphological changes, transformation of ET into RT, growth and reproduction of RT;
4. 4Morphological changes in RT, their transformation into ET, infectious particles;
5. 5Release of ET.

The entire process of reproduction and development of chlamydia takes place in modified vacuoles of the host epithelium. During morphological changes, the transformation of ET into RT and vice versa, a change in the size of epithelial vacuoles occurs.

3.1. Elementary bodies (ET)

Round, oval, optically dense particles. The diameter of the ET is 300 nm. The infection develops when ET attaches to specific receptors on the surface of the columnar and cuboidal epithelium of the urinary and reproductive systems (these types of epithelium cover the endocervix, endometrium, fallopian tubes, urethra).

3.2. Reticular bodies (RT)

After ET attaches to receptors on the epithelium, they are captured and penetrated into cell vacuoles. In the vacuoles of the epithelium, parasites are hidden from the host’s defense systems.

Inside the vacuole, the transformation of ET into RT occurs. The diameter of the RT reaches 1000 nm, these particles are capable of reproduction. Towards the end of the development cycle, a reverse transformation of RT into ET occurs in the epithelial cell, the epithelial cell ruptures and releases ET. ET infects new cells.

3.3. What increases the risk of infection?

Risk factors include:

1. 1Under 26 years of age. A strict association has been proven with an increase in the incidence of chlamydia among boys and girls and middle-aged people. Age is an important risk factor because in women, C. trachomatis usually infects the columnar epithelium of the endocervix. In young women, the columnar epithelium is ectopic, displaced from the endocervix (the epithelial lining from the cervical canal extends onto the vaginal part of the cervix) outward and is located on the ectocervix (the area of ​​the cervix facing the vagina). During sexual intercourse, the ectocervix comes into contact with sperm carrying ET chlamydia. With age, the ectopic columnar epithelium moves higher and moves to the endocervix.
2. 2Low socio-economic status. Incidence analyzes consider race and socioeconomic status together because they are closely related. Only 10 of 23 reports on the incidence of chlamydia among women and 1 of 4 among men indicate an increased risk of chlamydia among people of color.
3. 3Attitude to a group of social minorities.
4. 4 Refusal of barrier contraception. The use of barrier contraception reduces the risk of chlamydia infection.
5. 5 Combined hormonal oral contraception. Combined oral contraception leads to ectopic epithelium, increasing the likelihood of transmission of infection during sex.
6. 6Frequent change of sexual partners. This factor increases the risk of chlamydia due to the increased likelihood of encountering a carrier of the infection.
7. 7First sexual intercourse at an early age. The age at which sexual activity begins is an indicator of sexuality; it can indicate the patient’s possible promiscuity, indicate a frequent change of sexual partners, directly affecting the risk of developing STIs.

3.4. Pathogenesis of chlamydial infection

The mechanism of development of damage in tissues infected with chlamydia has not been fully studied, despite a good understanding of the pathological mechanisms of reproduction and development of parasites.

Some of the complications of the disease are associated with the reaction of the immune system, during which the produced antibodies lead to damage not only to bacteria, but also to healthy tissue. The destruction/limitation of chlamydia growth involves the mechanisms of antibody synthesis by plasma cells and activation of cytotoxic cells (CD8 T-lymphocytes).

Types of disease

Chlamydia in the eyes can cause the development of one or several pathologies:

• Uveitis. When the disease occurs, the lesion affects the mucous membrane.
• Trachoma. It is chronic in nature. Chlamydia can be found in both the cornea and conjunctiva. The disease is dangerous, if left untreated, there is a high probability of blindness.
• Paratrachoma. It differs from the previous version in that only the conjunctiva is involved in the inflammatory process. The remaining deep layers are unaffected.
• Meibomite. Infection occurs from sick animals. The disease affects the meibomian glands.

Sometimes doctors diagnose complex eye damage in conjunction with other organs. Depending on the location of the infection, the eyelids and connective tissues may be involved in the pathological process.

Chlamydia of the eye can be congenital or acquired. In the first case, infection occurs in the prenatal period, in the second - during passage through the birth canal. There is a high probability of pathology spreading, which can cause pneumonia, rhinitis, otitis media and damage to the respiratory system.

Characteristics of the pathogen

Due to the characteristics of the reproduction and development cycle, all chlamydia are classified into the family Chlamidiaceae, genus Chlamydia. Chlamydia trachomatis is one of four members of the genus. The remaining species are C. pneumoniae, C. psittacci, C. pecorum. Differentiation between species is made based on the analysis of DNA molecules.

C. psittacci most often infects birds and domestic animals, and less often infects people. C. pneumoniae is a cause of diseases of the human respiratory system (a common source of atypical pneumonia) and is also associated with the development of coronary heart disease. C. pecorum affects domestic animals.

There are 15 serovars of C. trachomatis, which are divided into serotypes AC (lead to the development of trachoma), DK (strains that affect the eyes and genitals), L1-L3 (strains that induce lymphogranulomatosis venereum, damage to the inguinal lymph nodes).

Most strains of C. trachomatis are identified by the production of monoclonal antibodies (mAbs) against epitopes of the bacterial outer membrane protein (VS4 MOMP). Chlamydia strains can be typed using serological or molecular genetic methods. Typing is necessary for epidemiological studies that are aimed at studying modes of transmission and geographic differences.

Causes of development of chlamydia in the eyes

Causes of development of chlamydia in the eyes

Transmission of the infection occurs through contact and household contact, when a person does not comply with basic rules of personal hygiene. Chlamydia can get on your hands from urogenital secretions of infected people in public places. Especially in toilets, swimming pools, saunas. Infection can also occur through contact with infected animals and birds.

The specificity of chlamydia conjunctivitis is that you can become infected in the absence of sexual contact. But the greatest risk is for people who are promiscuous. Sometimes eye damage becomes a prerequisite for checking the entire body for the presence of a hidden infection.

The risk group includes:

• Adults and children, if one of the family members is affected by chlamydia;
• Employees of medical institutions who have contact with infected patients;
• People who spend a lot of time in public places.

Preventive measures

To prevent chlamydia conjunctivitis, it is necessary to maintain personal hygiene, use an individual towel and not borrow personal items. It is important to be responsible when choosing a sexual partner and to use barrier contraceptives. Do not forget about the general strengthening of the immune system, a healthy lifestyle and undergoing a full examination at least 2 times a year.

These simple rules will help you protect yourself from unpleasant consequences and complications caused by chlamydia in the eyes.

Signs of pathology

Signs of pathology

With chlamydia of the eye, symptoms depend on which part of the organ is affected. The incubation period lasts 5-14 days. In most cases, only one organ of vision is affected. In the chronic course, the symptoms are mild, but patients often complain of frequent conjunctivitis and blepharitis.

In the acute form, infiltration foci form on the mucous membrane and transitional folds. Severe swelling of the eyelids appears. The pain is cutting in nature, combined with unbearable itching.

When infected with chlamydia, mucous or purulent discharge appears from the eyes. As the disease progresses, enlarged lymph nodes that are located behind the ears can be noted.

With chlamydia in the eyes, the symptoms are not always immediately acute. At first, the patient may feel normal discomfort in one eye, but after a few days, discomfort appears in the second eye. Gradually the mucous membrane acquires a red tint. unpleasant sensations appear in bright light and normal blinking.

In advanced stages, signs of an inflammatory reaction in the auditory tube may occur. During the transition from the acute phase to the chronic phase, moderate swelling of the eyelids and thickening of the conjunctival tissue are observed. Mucous discharge is not large in volume, but appears quite often.

Forms of chlamydial conjunctivitis

The forms of the disease are indicated in descending order from the most common to the relatively rare:

• ordinary chlamydial conjunctivitis;
• epidemic (pool, bath) chlamydial conjunctivitis;
• blepharitis;
• meibomite;
• episcleritis;
• uveitis;
• Reiter's syndrome (a combination of inflammation of the genitourinary tract, conjunctivitis and arthritis).

1- blepharitis; 2- meibomite

Diagnostics

Chlamydia is difficult to detect in the eyes, since there are few specific signs. The infection is similar to other bacterial lesions. Therefore, it is advisable to carry out a scraping for bacteriological examination. Chlamydia trachomatis is also detected using cytological examination. With it, cells are stained according to Romanovsky. This allows us to establish the presence of intracellular inclusions.

Biomicroscopy of the eye

Biomicroscopy of the eye is performed with a slit lamp. The method reveals swelling, the appearance of infiltrates and vascularization of the limbus. A fluorescein instillation test can be used, which reveals a violation of the integrity of the corneal epithelium. First, a special solution is introduced. The surface of the eye is examined using a blue slit lamp. The number of unpainted areas is counted.

The most labor-intensive and expensive is the cultural method. Results may not be obtained immediately, but within 48-52 hours. This method is effective if the scraping contains a minimal amount of pathogenic microorganisms.

Diagnostic tactics include conducting a full ophthalmological examination and obtaining consultations from a venereologist, urologist, gynecologist and some others.

Treatment of chlamydia on the eyes

Treatment of chlamydia on the eyes

Tetracycline antibiotics are often prescribed for the treatment of adults. They are not recommended for use in children, as they can lead to the development of other pathologies that impair the quality of life. Additionally, macrolides and fluoroquinolones can be used. For each patient, complex treatment is selected individually.

Doctors note that the use of local remedies without systemic ones will not bring the desired result. Chlamydia quickly adapts to mild antibacterial drugs. Therefore, serious treatment is immediately prescribed.

Systemic medications are used for up to three weeks. Treatment for ocular chlamydia includes the use of doxycycline-based drugs. If the disease is acute, then a two-week course is sufficient. In chronic pathologies, exposure lasts up to a month.

Chlamydia eye drops are used in addition to systemic treatment. They are introduced into the conjunctival sac. Ointments and gels are applied by application up to 6 times a day. After 2 weeks, the dosage is reduced.

Popular methods are:

• Tetracycline, Erythromycin ointments;
• Ciprofloxacin, Ofloxacin in the form of drops.

  
  Tetracycline ointment

  
  Erythromycin ointment

  
  Ciprofloxacin

  
  Ofloxacin

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The use of systemic and local antibiotics can cause allergic reactions. To reduce the risk of their occurrence, drugs that relieve inflammation (hormones) and improve tissue trophism are prescribed. If there are prerequisites for the growth of the fungus, then it is additionally advisable to use drugs based on nystatin.

Acute symptoms disappear in the second week after treatment. Doctors prescribe eye drops for chlamydia in combination with antihistamines. They can not only reduce the risk of allergic reactions, but also reduce swelling.

You can speed up the healing process if:

• Carefully remove crusts formed by mucus after waking up in the morning;
• As purulent discharge accumulates, remove it with sterile wipes;
• Carry out thorough eye hygiene regularly.

During treatment, symptoms of “dry eye” may occur. To eliminate the symptom, tear replacement therapy is used. To do this, you need to drip Oftolik, Natural Tear, Systane Ultra 4 times a day for 6 months.

Ophtolic

Natural tear

Systane Ultra

Traditional methods of treatment

Good results can be achieved if you consume wormwood. For treatment, dry grass is taken and crushed into powder. You need to eat a pinch every 2 hours for 3 days. There are no breaks even at night. After this, the powder is drunk 5 times a day for 4 days. The duration cannot be more than a week.

You can take echinacea to boost your immunity. One large spoon is filled with 0.5 liters. boiling water The decoction is infused in a thermos for 12 hours. You should drink 150 ml three times a day up to 30 minutes before meals.

Wormwood

Echinacea

You can make an infusion from plantain seeds. Two teaspoons are poured into a glass of boiling water. The mixture is infused for 30 minutes and filtered. The resulting decoction can be used to gently treat the eyelids.

Prognosis and prevention

Healthy eyes

The criteria that the treatment was effective are:

• Signs of regression of symptoms;
• Negative laboratory tests.

The latter are repeated every 2-4 weeks three times. The consequences of chlamydia in the eyes can vary. With rational therapy, complete recovery occurs. If the treatment is chosen incorrectly, then a recurrent course and blindness are possible.

Prevention of the disease includes timely detection of urogenital chlamydia and the use of individual hygiene items. When visiting the pool, eyes should be protected using special glasses.