Eye disease chlamydia. What is chlamydial conjunctivitis: symptoms and treatment. Features of pathology in children and pregnant women

Chlamydia of the eye occurs in 10-30 people out of 100 who contact an ophthalmologist with a complaint of signs of conjunctivitis. Pathological processes occurring in one or affecting both eyes at once significantly spoil the quality of life. Redness, burning, pain and a feeling of sand in the eyes do not allow you to carry on as usual, work and communicate with people.

Damage to the organs of vision by chlamydia

The eye is a pathology caused by the proliferation of bacteria of the genus Chlamydia. Characterized by inflammation, swelling and redness of the mucous membranes of the conjunctiva. Damage to the visual apparatus acts as concomitant disease to the main one - urogenital chlamydia.

After infection incubation period is 2-4 weeks. During this time, bacteria multiply in the pelvis, affecting the genitals. With chlamydia of the eye, the incubation period is much shorter and lasts from several days to a week. IN in rare cases it reaches a month. A person does not suspect the presence of a pathogen in the body, but at the same time he himself becomes a source of infection. With chlamydia of the eye, symptoms appear acutely, but not always.

Chlamydia of the eyes is not necessarily accompanied by damage to the urogenital tract. However, more than half of the patients have a mixed form of infection. Pathology can be diagnosed only through laboratory tests and a medical examination. For selection effective treatment Bacteriological culture will be required.

Forms of the disease

Chlamydia of the eyes in patients occurs in different forms. The names of the diseases and their symptoms differ. In the doctor's office you can hear such diagnoses as:

• ophthalmochlamydia;
• chlamydial conjunctivitis;
• paratrachoma and trachoma (adults or newborns);
• chlamydial inflammation vascular walls- uevitis;
• pool conjunctivitis;
• chlamydial episcleritis ( inflammatory lesions tissue located between the sclera and conjunctiva);
• meibolitis of a chlamydial nature (inflammation of the meiboli gland);
• Reiter's syndrome.

The course of the infection is often chronic. At first, the bacterial pathogen is present in the patient’s body without causing concern or symptoms. Getting worse chronic conjunctivitis because of improper treatment, which patients often resort to on their own.

Ways of contracting an infection

Chlamydial conjunctivitis has different transmission routes. The likelihood of infection increases for people suffering from genital chlamydia. If the patient knows about his illness, then he should be careful so that the infection does not spread to the organs of vision.

Among the methods of infection are:

• The everyday way of acquiring bacterial conjunctivitis is through personal hygiene items. You can spread the infection from the genital tract to the eyes with a towel. You can transmit the disease in this way not only to yourself, but also to other people using this towel. Conjunctivitis caused by chlamydia can be transmitted from one woman to another if they share decorative cosmetics: mascara, eye shadow, eyeliner.
• Chlamydia in the eyes begins to multiply after mixed sexual intercourse. Orogenital intercourse becomes immediate cause infection. With them, the infection penetrates into the organs of vision from the genitals directly.
• Chlamydia of the eye is transmitted through water. The penetration of the pathogen into a stagnant body of water contributes to the infection of other swimmers. Doctors call chronic form eye disease pool conjunctivitis. With low concentrations of chlorine in specialized swimming ponds, you can easily catch the disease. Penetration of the pathogen into the body healthy person also occurs through water public places ah (toilets, baths, saunas).

Who is at first risk of becoming infected?

People having increased danger infections are identified as risk groups.

• Doctors occupy the main place at risk. Obstetricians, gynecologists and infectious disease specialists are susceptible to chlamydial eye infections. They have direct contact with the source of the pathogen. Bacterial conjunctivitis in doctors develops after the bacteria are transferred through the hands.
• There is a high risk of infection among children and other family members of the patient. The infection is transmitted through personal hygiene items, common use items, or carried on the hands. Sick man with high probability can infect her sexual partner and acquire conjunctivitis on her own.
• Chlamydial conjunctivitis often affects those who like to visit a sauna, bathhouse, or swim in a pool. Going on vacation near an open body of water, a person is already exposing himself to danger. After swimming in a pool, river or pond, the risk increases significantly. The penetration of water into the eyes is highly likely to guarantee that signs of illness will appear after some time.
• Newborn children are also at risk. They have a different way of acquiring the disease. Babies can become infected while still in the womb. The pathogen also affects the visual organs of a newborn during its passage through the birth canal. This route of acquiring ocular chlamydia is called vertical. People who work with infected newborns are also at risk of getting sick.

All these people should exercise caution and undergo regular examinations. If detected, begin treatment immediately. The infection does not form immunity; once cured, a person can become infected again.

What symptoms might there be?

The main symptom of eye disease is redness and swelling of the organs of vision. There are acute, subacute and chronic course infectious process. Acute chlamydial conjunctivitis is accompanied by the following manifestations:

• redness of the white of the eye;
• redness of the inner mucous membrane;
• burning, itching, discomfort;
• tearfulness and photophobia;
• discharge of pus from the conjunctival zone when pressed;
• swelling of the upper and lower eyelids;
• formation of compactions on the cornea.

Acute chlamydial conjunctivitis occurs in a bright form. At this stage, they can be easily cured by determining the sensitivity of the pathogen. With improper and untimely use of drugs, as well as self-medication, a chronic form of the disease occurs. It is characterized by less pronounced symptoms. However, mild symptoms do not indicate the retreat of the disease and the patient’s recovery. The infection continues to spread, changing its latent course to an active one. At chronic illness a person is worried about periodic conjunctivitis and blepharitis.

Diagnostic principles

An examination of a patient who complains to an ophthalmologist is carried out in several stages. A complete diagnosis can determine not only the type of pathogen, but also select drugs that can eliminate it.

A preliminary diagnosis is determined by the symptoms of the disease. The doctor interviews the patient, learns about his complaints, and then conducts a visual examination of the eyes. All information is entered into the patient's card. The information received is called clinical picture. During the examination, the specialist may find additional manifestations that the patient did not notice: the formation of follicles in the lower eyelid, hypertrophy of the mucous membrane, scarring of the cornea.

Laboratory testing is an integral part of diagnosis. It includes three stages, the passage of which gives an accurate diagnosis:

• scraping and determination of the presence of chlamydial infection in the material taken (cytological, enzyme immunoassay method or polymerase chain reaction);
• sowing (selecting into cell culture chlamydia);
• serological testing.

The method of seeding cell cultures has an advantage. This method allows you to determine not only the type of pathogen, but also to establish groups of drugs effective against the pathogenic microorganism. The disadvantage of bacteriological testing is its high cost and long waiting time. It will take 2 to 3 days to get results. Fast and more perfect way detecting chlamydia is carrying out enzyme immunoassay blood.

Therapeutic techniques

Treatment of conjunctivitis of chlamydial origin requires a lot of time and expense. It is necessary to eliminate the pathogen completely: in the eye and genital tract areas. Otherwise, after recovery, the patient may become infected again within a few days. No immunity is developed against this bacterium.

The patient will have to use several remedies at once: local, systemic, symptomatic. Only in this case can you count on destroying the pathogen. After drug correction, a recovery course will be required, including the use of immunomodulators, probiotics and vitamin complexes.

“Treatment for chlamydial infections of the eye and pelvis is recommended for both partners. All people living with them should also be examined and, if necessary, undergo preventive treatment.”

Drug treatment

Usage local drugs without systemic means it will be ineffective.”

Microorganisms quickly adapt to mild antibiotics, developing resistance. In the future, eliminating the pathogen will be more problematic.

Systemic drugs are used for 7-21 days. Patients are prescribed tablets or medications for injection. The generally accepted recommended regimen includes the use of doxycycline-based drugs (Unidox, Vibramycin). The acute course of the infection requires a two-week course, and the chronic course is corrected over the course of a month. Therapy is supplemented by the appointment of azithromycin and erythromycin. Based laboratory diagnostics can be used:

• Clarithromycin;
• Vilprafen;
• Spiramycin;
• Ofloxacin;
• Tetracycline;
• Ciprofloxacin.

The dosage of drugs is determined individually. Sexual partners may also receive different recommendations. The doctor takes into account the patient’s age, the severity of the disease, the presence of concomitant pathologies and the likelihood of pregnancy in women.

Eye drops and ointments are prescribed in combination with system means. Drugs are administered into conjunctival sac or applied by application up to 6 times a day. After 1-2 weeks, the dosage and frequency of use is reduced in accordance with the doctor’s recommendations. Treatment lasts 3-4 weeks using medications:

• Tetracycline and Erythromycin ointment;
• Ciprofloxacin and Ofloxacin in the form of drops (can be combined with systemic drugs based on the same active ingredients);
• Lemofloxacin, Norfloxacin.

Using drops containing an antibacterial substance may cause unexpected reactions the body in the form of allergies or toxic manifestations. To avoid such consequences, doctors prescribe corticosteroids in combination with agents that improve tissue trophism: Dexamethasone or Hydrocortisone. Additionally, Taufon and Oftagel drops are used. To prevent fungal infections, drugs based on nystatin are used. At the end of therapy, the patient is recommended to take a course beneficial bacteria to restore microflora: Acylact, Maxilak, Bifiform.

“After 10-15 days, a repeat test is taken, which shows the effectiveness of the therapy or the need to choose additional treatment. Positive result the disappearance of symptoms and the absence of chlamydia in the smear is considered.”

Using additional techniques

The effectiveness of treating ocular chlamydia with folk remedies is questioned by doctors. Experts warn patients about the consequences of improper treatment. Doctors do not prohibit resorting to known folk recipes, if the patient believes in their effectiveness, however drug treatment such methods cannot replace. In the treatment of bacterial conjunctivitis the following are used:

• diet (refusal of alcohol, sweets, fatty and salty foods, preference for fermented milk dishes, vegetables and whole grain cereals);
• herbal remedies (extracts of ginseng, eleutherococcus, echinacea to strengthen the immune system);
• anti-inflammatory eye lotions (calendula, chamomile, oregano).

Herbal decoctions are injected drop by drop into each eye to cleanse pus.

Prevention of infection

In order to prevent infection with chlamydia conjunctivitis, the following precautions must be taken:

• use a separate face towel, individual for each family member;
• avoid using other people’s decorative cosmetics (including testers in a store; when visiting a makeup artist, have your own decorative products);
• have a regular sexual partner, observe barrier contraception;
• be periodically checked for infection;
• minimize visits to public swimming pools, saunas and baths;
• don't exchange underwear, and also do not try it on in the store;
• strengthen the body's protective functions, increase immunity.

“When planning a pregnancy, partners need to be examined, since chlamydia can cause serious problems, and the use of many antibacterial agents and drops are contraindicated for expectant mothers.”

Chlamydial conjunctivitis develops for one of the following reasons:

• rubbing the eyes with dirty hands;
• visits to public saunas, baths, swimming pools;
• neglect of hygiene rules;
• using someone else's towels or eye care products.

You can become infected with microorganisms that cause chlamydial conjunctivitis at an appointment with a doctor (gynecologist, urologist, dermatovenereologist, ophthalmologist) during an examination using unsterile or poorly sterilized instruments.

However, most often this pathology develops in people with chlamydia genitourinary tract. In 50% of diagnostics, pathogens pathological process found on the mucous membranes of the eyes and genitals.

Forms of the disease

Chlamydial conjunctivitis has its own classification, according to which it is divided into the following forms:

• trachoma;
• paratrachomas (in adults);
• blenorrhea (conjunctivitis of newborns);
• pool;
• epidemic (in children);
• HC accompanying Reiter's syndrome;
• chlamydial meibomite, which is zoonotic in nature.

In addition, there are also keratitis, episcleritis and other ophthalmological pathologies caused by the addition of chlamydial microflora.

Clinical manifestations

The symptoms of chlamydial conjunctivitis depend on the form in which it occurs. But they often appear at later stages of progression of the pathological process. If it has just begun, the disease can be latent, that is, completely asymptomatic.

The incubation period for the development of chlamydial conjunctivitis lasts from 6 to 14 days. Often one visual organ is affected first, but if the first signs of the pathological process are ignored, the disease can spread to the second.

Symptoms of acute chlamydial conjunctivitis can manifest themselves due to the occurrence of:

• swelling of the conjunctival sac;
• hyperemia of the eyeball;
• increased lacrimation;
• photophobia;
• swelling of the mucous membranes of the eyes;
• pain and pain in the eyes;
• discharge of sticky (purulent) eye secretion.

At later stages of development, chlamydial conjunctivitis can cause the development of eustachitis, as well as lead to hearing loss and the occurrence of noise and ringing in the ears.

The chronic form of the pathological process is considered sluggish due to the mild severity of its symptoms. However, it is no less dangerous, so treatment is necessary in any case.

Which doctor treats chlamydial conjunctivitis?

If symptoms characteristic of chlamydial conjunctivitis occur, you should consult an ophthalmologist.

Risk group

Chlamydial conjunctivitis is most susceptible to:

• children;
• aged people;
• persons with weak immunity;
• diabetics.

People who engage in disorderly behavior are also at risk. sex life. Under such conditions, the risk of “catching” genital chlamydia is the highest, and even modern methods protections that provide safe sex, are not always effective.

Diagnostic features

Diagnosis of chlamydial conjunctivitis consists of an initial ophthalmological examination. It is performed using a slit lamp, after which the ophthalmologist may prescribe other diagnostic procedures:

• Instillation fluorescein test. This laboratory test carried out to exclude chlamydia damage to the ocular cornea.
• Cytological examination.
• Immunofluorescence analysis - ELISA.

These procedures are especially important for differential diagnosis, as they will help distinguish chlamydial conjunctivitis from adenoviral conjunctivitis.

Effective therapies

Treatment of chlamydial conjunctivitis in most cases is limited to the use of medications, and only in difficult situations surgical intervention is possible.

Conservative therapy implies the mandatory use of antibacterial drugs belonging to the groups of macrolides, fluoroquinolones and tetracyclines.

Also an important component of the treatment of (local) chlamydial conjunctivitis are antiseptic, anti-inflammatory and antimicrobial ophthalmic solutions for instillation of the eyes:

• Ofloxacin;
• Ciprofloxacin;
• Dexamethasone (drops);
• Indomethacin;
• Floxal et al.

Pathology should be treated comprehensively, so another component of therapy is ointment applications on the eyes. Ointments should also have an antibacterial and antiseptic effect (Tetracycline, Erythromycin). Concerning systemic treatment chlamydial conjunctivitis, it is carried out according to the treatment regimen for sexually transmitted diseases (STDs).

Features of pathology in children and pregnant women

Paratrachoma, or chlamydial conjunctivitis in children is not so rare. Those at risk are primarily adolescents who begin sexual activity early. At the same time, girls suffer from pathology more often than boys.

The disease can be transmitted vertically (placentally), in which case the newborn child will be infected. With the development of chlamydial conjunctivitis, children complain of pain and pain in the eyes, the appearance of pus, and the development of rhinitis (runny nose). With a protracted course of the pathology, there is an increase lymph nodes(lymphadenopathy).

HC in expectant mothers

The development of chlamydial conjunctivitis during pregnancy is caused by changes in hormonal background and significant weakening immune system. If pathology is detected in expectant mother treatment should be prescribed immediately. However, it should not cause harm to the fetus, so the woman herself can only use products traditional medicine.

This type of conjunctivitis during pregnancy is dangerous because chlamydia can spread to the mucous membranes different organs, including the genitals. Intrauterine infection of a child can cause serious harm to his health after birth, which can result in the same often recurrent conjunctivitis and other ophthalmological pathologies.

Folk remedies for the treatment of pathology

Recipes give good results in the treatment of chlamydial and other types of conjunctivitis alternative medicine. However, remember that they should only be used in combination with medications, since they are not suitable as an independent therapeutic technique.

Below are the most effective recipes aimed at stopping purulent discharge from the eyes and cupping inflammatory process in tissues.

Chamomile decoction

Chamomile has anti-inflammatory, soothing and antiseptic properties. To prepare a medicine for the eyes, you need to pour 5 g of dried flowers into 300-450 ml hot water and simmer over low heat for 7-8 minutes. Let the broth brew and cool slightly, then moisten a sterile piece of gauze or cotton wool in it and apply it to the eyes. Repeat the procedure 7-10 times a day.

Chamomile decoction can be used for the treatment of chlamydial conjunctivitis in young children and infants. But you need to make sure that it is not too rich, otherwise pain, burning and itching of the eyes may occur.

Plantain seeds

Plantain seeds must be crushed well in a mortar, then take 2 tbsp. l. raw materials and pour a glass of boiling water. Let it brew in a closed container for 40-50 minutes, then strain well. The finished infusion is used to wash the eyes or as warm lotions.

Propolis-based drops

A good remedy to help quickly get rid of chlamydial conjunctivitis is eye drops based on bee glue. However, it should absolutely not be used by people prone to allergies - this can lead to dangerous consequences.

To prepare the product, you need to grind a propolis stick to a powdery state and mix with boiled water in a ratio of 1:5 respectively. Leave for several hours, then strain and apply as eye drops 2-3 times a day.

Possible complications of pathology

With absence timely treatment complications of chlamydial conjunctivitis in children and adults can be:

• scars that form on the surface of the cornea of ​​the eye;
• decreased visual acuity.

But in most cases, the pathology is successfully cured and does not lead to similar consequences. Complications can arise only in the presence of a sluggish chronic form of chlamydial conjunctivitis, the symptoms of which have been ignored by the patient for a long time.

Prevention measures

Any disease is easier to prevent than to treat, therefore, in order to avoid the development of chlamydial conjunctivitis, it is necessary to take a responsible approach to the issue of its prevention. To prevent the development of pathology it is necessary:

• wash your hands thoroughly after each visit to the restroom, saunas, baths and other public places, as well as after coming from the street;
• practice only safe sex, protect yourself with condoms;
• do not rub your eyes with dirty hands, especially on the street, in a hospital, public transport and in crowded places;
• carry with you antiseptic solution– if necessary, you can always use it if there is no place nearby where you can wash your hands;
• avoid using other people's products and hygiene items;
• use only individual cutlery;
• avoid examinations with a gynecologist using “general” instruments; pharmacies sell sterile gynecological kits for one-time use;
• address the issue of strengthening the immune system.

Persons who are promiscuous should undergo regular preventive examinations by specialized specialists (dermatovenereologists, gynecologists or urologists-andrologists). The presence of chlamydial infection on the mucous membranes of the genital tract will sooner or later cause the development of not only conjunctivitis, but also other diseases that can cause significant harm to a person’s health and significantly reduce his quality of life.

Useful video about conjunctivitis

Chlamydial conjunctivitis develops due to chlamydia entering the eye mucosa. For example, bacteria can enter the conjunctival sac through personal items or hands contaminated with body fluids.

In this case, the carrier of the pathogen can transmit it both to their own mucous membranes, but also to the mucous membranes of a partner or child. Chlamydia of the mucous membranes of the eyes is almost any lesion of the mucous membrane of the visual organ.

According to medical research, this type of disease accounts for more than a third of all cases of mucosal inflammation.

Prerequisites for development

Chlamydial conjunctivitis can affect both adult women, men and children. It manifests itself in the following types:

• paratrachoma;
• trachoma;
• pool conjunctivitis;
• chlamydial episcleritis;
• chlamydial uveitis;
• chlamydial meibolith;
• conjunctivitis with Reiter's syndrome.

Most often, these problems become just part of the whole complex with the development of chlamydial infection in newborns or adult patients.

The main ailment for problems caused by chlamydia is considered to be urogenital chlamydia, which develops in the organs genitourinary system.

Most often, chlamydia is transmitted through unprotected sexual contact. In the case of direct infection of the visual organ, it can be assumed that vaginal fluid or infected semen has come into contact with the mucous membrane.

Let us note separately that chlamydia often occurs with virtually no symptoms, and conjunctivitis can be an indicator that this infection is beginning to develop in the body.

Although there may be no other symptoms at all, both in children and adult patients.

This is one of the most insidious dangers of infection, which greatly complicates the process of diagnosis and accurate detection of the disease on early stages and without laboratory tests.

Conjunctival lesions of the eyes of newborns and children can develop as a result of accidental transmission of infection to the eyes. If there is no treatment, the disease will become chronic.

• Obstetrics and gynecology,
• Venereology, doctors here are constantly in contact with contaminated biological materials,
• Urology.

You can become infected with chlamydial conjunctivitis even in public places - such as a bathhouse or sauna, or a swimming pool. Despite the fact that the bacterium is practically not adapted to life outside the cell, it can enter the mucous membrane of the eyes with liquid and begin to develop there.

This occurs when there is not enough chlorine in the water to be safe.

In some cases, chlamydia can be transmitted from newborns, but this is extremely rare.

At congenital chlamydia, the disease is accompanied by serious damage to other systems and internal organs(photo).

The most unpredictable form of chlamydia in a newborn child is chlamydial infection of the respiratory system.

If the pathogen spreads through the sinuses, children and newborns may experience:

• rhinitis;
• eustachitis;
• severe damage to the respiratory system;
• acute otitis;
• nasopharyngitis.

Pathogenesis of chlamydial conjunctivitis

Infection of the eyes during the development of chlamydia is often defined as simple blepharitis. This conclusion is quite logical, because chlamydia may practically not appear.

In some cases, frequent relapses help to suspect chlamydia, but the pathogenesis of the disease is quite interesting.

The manifestation of the ophthalmological type of chlamydial infection can be directly related to several factors:

• duration of the disease;
• localization of chlamydia in the patient’s body;
• individual characteristics of the body and its response to the penetration of a foreign microorganism.

The eye in adults and newborns can leak from 2 to 7 days.

There are cases when this period can increase to a month.

IN initial stage, one eye is the first to be affected, then the infection, not without the help of the patient himself, reaches the mucous membrane of the second eye.

It is noted:

1. obvious redness of the mucous membrane of the eye;
2. lacrimation, eyelids begin to stick together in the morning;
3. patients note the appearance of photophobia.
4. Almost every patient from 3-5 days will suffer:
5. preauricular adenopathy on the affected side (disease of the lymph nodes located in front of the ear);
6. eustachitis (inflammation auditory tube).

Chlamydial conjunctivitis can be acute or chronic.

The pathogenesis of the acute form will be accompanied by severe swelling of the eyes with abundant mucopurulent exudate, swelling of the conjunctiva, and damage to the cornea.

In almost 50% of all cases of infection, enlargement of the follicles in the lower eyelid can be noted.

And in a third of patients, the conjunctiva enlarges upper eyelid and compaction of all tissues of the conjunctiva (both in adults and newborns).

If chlamydia of the eyes (photo) becomes a chronicle, then in this case the following will be noted:

• slight swelling of the eyelids;
• thickening of the conjunctival tissue;
• light discharge from the eyes.

The result of chlamydial damage to the visual organ in children and newborns can be ambiguous. Symptoms of scarring of the cornea and conjunctiva, as well as relapses, may not always be manifested, which suggests that the disease can be asymptomatic.

Who is at risk

The range of potential patients is quite wide. So, they can become infected:

• sexually active men and women of almost any age (who suffer from recurrent or chronic conjunctivitis);
• patients with urogenital chlamydia;
• their sexual partners and family members;
• patients with conjunctivitis in the acute stage;
• patients with recurrent conjunctivitis;
• newborn children from mothers suffering from chlamydia.

Only after confirming the diagnosis of chlamydial conjunctivitis (acute or chronic) will the doctor prescribe appropriate treatment.

How to identify the disease

The most vulnerable place for non-urogenital chlamydia is the eyes.

Chlamydial conjunctivitis can be diagnosed based on a simple examination of the mucous membranes and using laboratory methods analysis.

In general, the first method does not provide 100% accuracy and information content.

Today the most informative ones are considered to be following methods research:

• detection of chlamydia through scraping. Cytological, immunoenzyme, immunofluorescent methods, polymerase chain reaction can be used;
• isolation of infections in cell culture. A cultural method for detecting ocular chlamydia in modern medical practice considered a reference;
• blood test in children and newborns.

For analysis, biological material is collected from inner surface eyelid, naturally, after pain relief.

Treatment of chlamydial conjunctivitis

The biggest mistake is to treat chlamydial eye lesions in newborns and adults with local antibiotics.

Such an approach, based only on a visual examination of inflammation (without identifying the causes), will not give absolutely any results. Chlamydia has virtually no sensitivity to antibiotics used (for example, these can be drops).

Chlamydial conjunctivitis is an extremely dangerous disease, which does not tolerate unauthorized treatment and ignoring symptoms!

If the treatment is not targeted, then the disease becomes chronic type infection of the visual organ, and is characterized by further active spread throughout the body.

It is for this reason that timely delivery of all necessary tests, and subsequent complex therapy conjunctivitis, both in adult patients and in newborns, children, and adolescents.

For effective treatment, finding out the cause of the disease is not enough. It is necessary to find out the degree of its sensitivity to certain medications.

If therapy had already been carried out previously, then surviving chlamydia could well have developed resistance to it.

In this case, treatment will be ineffective, chronic illness and characteristic symptoms will continue to torture the patient.

Dosage medicines internal introduction(treatment of the disease) must be determined taking into account the severity of the disease. The doctor may prescribe:

• eye drops;
• antihistamines.

Drops should be selected in individually and focusing on probable related problems health problems that are asymptomatic.

Treatment of chlamydial conjunctivitis takes up to 3 weeks. At this time, the symptoms of the disease disappear and the infection dies.

As soon as treatment is completed, it is necessary to carry out control laboratory tests.

It is highly desirable that crossover methods be used.

Chlamydial conjunctivitis is called infectious inflammation conjunctiva caused by chlamydia. It is also called chlamydia or ophthalmochlamydia. This is a rather dangerous disease that can lead to loss of visual acuity without proper treatment. Therefore, it is important to recognize the disease in time and begin treatment.

The main causative agent of chlamydia is the bacterium Chlamydia trachomatis. This microorganism capable of forming special L-shapes which allows him for a long time remain unnoticed in "sleep" mode. Go to active phase occurs in the following cases:

• violations of habitual temperature regime(overheating, hypothermia);
• ARVI;
• infectious diseases;
• period of immunosuppression;
• long course of taking antimicrobial agents.

Moving into the active phase, chlamydia begins to reproduce and occupy certain areas of the body. IN in this case The mucous membrane of the eye is “attacked”.

However, lesions may vary depending on the serotype. There are three main types:

• A, B, Ba and C. Promote the development of trachoma;
• D-K is the main cause of paratrachomas, chlamydia and urogenital chlamydia;
• L1-L3 contribute to the development of lymphogranulomatosis in the groin area.

Types of disease

Chlamydial conjunctivitis may have various shapes with different manifestations and symptoms.

1. Trachoma (is a chronic form of the disease, complications from which can lead to blindness. Today, trachoma is very rare in developed countries. Its main range is in countries where it is characterized by low level sanitation (for example, in Africa or the Middle East)).
2. Paratrachoma (usually occurs in acute form, manifested by edema and hyperemia with the formation of loose follicles).
3. Epidemic (basin) chlamydial conjunctivitis in children.
4. Chlamydial conjunctivitis in newborns.
5. Chlamydia with Reiter's syndrome (inflammation of the eyes occurs when the infection spreads from the joints).
6. Meibomitis is zoonotic (occurs when conjunctivitis is contracted from animals).
7. Chlamydial keratitis (microorganisms affect the cornea of ​​the eye).
8. Chlamydial uveitis (damage to the choroid).
9. Chlamydial episcleritis (a disease of the connective tissues in the eye).

All types of chlamydia can be acute, subacute or chronic.

Infection

In adult men and women, chlamydial conjunctivitis most often develops due to bacteria from the genitals entering 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.

Symptoms of the disease become most noticeable after the incubation period, which can range from several days to two weeks. The bacteria usually affects one eye, but sometimes the infection spreads to the other eye. In the absence of timely treatment, chlamydia can become chronic.

The chronic form usually has a sluggish character without bright severe symptoms. Chlamydia manifests itself in this case mild swelling, accumulation of blood in tissues in adjacent areas (hyperemia), as well as various discharges from the eyes.

The acute form of chlamydial conjunctivitis and exacerbation of the chronic form are distinguished by a number of stronger symptoms:

• itching, pain in the eyes;
• swelling and swelling;
• photophobia;
• damage to the auditory tube and hearing impairment;
• compactions on the cornea;
• copious purulent and mucous discharge;
• follicle formation;
• sticking of eyelids on waking;
• lacrimation.

The acute form can last up to three months, after which it turns into chronic conjunctivitis. Some symptoms may go away on their own.

In a child, chlamydial infection manifests itself as:

• inflammation of the pre-auricular lymph nodes;
• ear inflammation (otitis);
• inflammation of the nasopharynx (nasopharyngitis);
• chlamydial pneumonia (infectious and inflammatory process in the lungs).

Diagnosis of the disease

If you suspect the development of chlamydia, you should visit an ophthalmologist, whose competence includes prescribing appropriate examinations and tests. Most likely, you will also need to visit a gynecologist or urologist, venereologist, rheumatologist and otolaryngologist.

Primary diagnosis involves collecting detailed information about pre-existing diseases and visual inspection eye. For a more accurate diagnosis, there are a number of methods:

1. Linked immunosorbent assay.

This method involves measuring the level of antibodies to chlamydia. The tests allow us to determine the type of pathogen and the nature of the disease (acute or chronic). The downside is that diagnosis can only be carried out in the second week of the disease, and the accuracy of the procedure is only about 60%.

1. Polymerase chain reaction.

This type of research consists of a multiple selective increase in the number of molecules of the material being studied in a laboratory setting.

1. Culture for chlamydia.

One of the most expensive methods, requiring several days to complete. This diagnostic good because it allows you to find out the level of sensitivity to the pathogen.

1. Immunofluorescence.

The material taken from the patient is thoroughly examined using a fluorescent microscope. However, the accuracy of such a study is about 50%.

1. Microscopic analysis(cytology).

Samples of smears from the urethra, vagina and cervix are taken for research, as well as urethra. This method shows rather low efficiency, detecting only about 15% of infections.

Tests make it possible to exclude other types of conjunctivitis from a possible diagnosis and more accurately create a treatment regimen.

In order to cure a disease, it is necessary to first determine the cause of the disease. It is also necessary to establish the degree of sensitivity of pathogens to antibiotics if they have previously been treated with them. It may turn out that they have developed immunity to the drugs used.

When prescribing treatment, the doctor must take into account the characteristics of the patient’s health condition. In particular, the presence of other chronic and hereditary diseases, as well as pregnancy and breastfeeding, etc.

It should be borne in mind that only a doctor can correctly draw up a treatment plan. Self-medication is unacceptable, especially the use of antibiotics, which can only complicate the situation by the development of allergies, dysbacteriosis, liver overload, or the development of immunity in chlamydia to substances in the drug.

In general, treatment can be divided into two areas:

• systemic treatment. This is a long course that can take six months or even a year;
• local treatment. An equally important type of therapy, the main task of which is to reduce the manifestation of symptoms. For this purpose they are appointed various drops and ointments with anti-inflammatory and antibacterial action.

Drug treatment

The treatment process depends on the development cycle of chlamydia, since their adaptation to drugs occurs at certain stages. As a result of waiting for these cycles to change, treatment can last from a month to six months, and in severe cases- and up to a year.

For full recovery it is necessary to carry out several parallel different types events.

1. Prescription for internal and external administration of antibacterial drugs of the following groups:

• fluoroquinolones (Moxifloxacin, Levofloxacin, etc.);
• macrolides (Roxithromycin, Azithromycin, Spiramycin, Erythromycin, etc.);
• tetracyclines (Monoclin, Vibramycin, Doxycycline, etc.).

1. Use of anti-allergenic drugs (Cetrin, Erius, Zyrtec, etc.).
2. Taking corticosteroids and trophic preparations to remove side effects antibiotics and stimulate metabolism.
3. Purpose antifungal agents and eubotics to improve microflora (Linex, Lactobacterin, Levorin, Nystanin, etc.).

Upon completion of the course of treatment, it is necessary to retake several types of tests at intervals of about a month in order to accurately verify the effectiveness of the measures taken. This will prevent the disease from becoming latent or chronic stage, as well as relapses and complications.

Treatment with folk remedies

Strictly speaking, treat chlamydial conjunctivitis traditional methods not the best effective solution. However, as an addition, for general strengthening body, improving immunity and relieving symptoms, traditional medicine is perfect.

For example, for any form of chlamydia, infusions and decoctions can be recommended for washing the mucous membrane of the eyes and cleansing purulent discharge.

Here are some more detailed recipes.

• Infusion of flowers medicinal chamomile. Take two or three tablespoons of chamomile per 1 liter of hot water and leave to infuse in a sealed container for an hour. After filtering the infusion, it can be used to wash the eyes several times a day.
• Infusion of plantain seeds. Take two teaspoons of crushed seeds per glass of boiling water. The mixture is infused for half an hour, after which it is filtered. The resulting infusion is suitable for washing the mucous membranes and lotions.
• A mixture of elderberry, cornflower and flax. Herbs are taken in equal proportions at the rate of one tablespoon (heaped) of the mixture per two glasses of hot water. The composition should be infused for about 8-10 hours. dark place, after which it needs to be strained. The infusion is suitable for washing and lotions.
• A mixture of hop cones and blueberry leaves. The ingredients are taken in equal proportions. For one tablespoon of the mixture you will need a glass of boiling water. Leave for at least an hour. The infusion is intended for drinking - three times a day, three sips half an hour before meals.
• Propolis solution (bee glue). First, it is ground to a powder, then poured with water in a ratio of 1 to 5. After filtering, it can be used as eye drops two to three times a day.

Most accessible means For washing the eyes, use black or green tea.

Prevention

It is well known that it is better not to treat a disease, but to prevent it. To do this, it is enough to follow a number of simple measures:

• wash your hands regularly;
• use protective glasses in swimming pools;
• do not touch or rub your eyes unnecessarily, especially in public places;
• do not use other people’s hygiene items or cosmetics;
• use disposable or individual tableware, the same applies to medical supplies and hygiene products;
• strengthen general immunity.

To prevent conjunctivitis, it is also necessary to identify and treat urogenital chlamydia in time so that it does not spread to the eyes.

If you suspect chlamydia, you should definitely consult a doctor, as inaction can lead to complete loss vision. The disease progresses differently in most people, but it can still be distinguished - first of all, by the appearance of purulent discharge.

Chlamydia is a disease that primarily affects the genitourinary system. However, there are other localizations. Chlamydia of the eye, for example, is a fairly common complication of infection. It occurs in approximately ½ of patients with the urogenital form of the disease. Chlamydial conjunctivitis accounts for 10-14% of other inflammations of the mucous membrane of the eye.

There are several clinical forms diseases. Conjunctivitis does not lead to irreversible changes in the cornea of ​​the affected eye. Trachoma, in the absence of proper treatment, often ends in blindness. Due to the danger of such a complication, therapy for chlamydial infection should be carried out in a timely manner, until the pathogen is completely expelled.

Etiology

Chlamydia of the eye is quite common

Chlamydial infection of the organs of vision occurs when infected material (for example, discharge from the genitals) comes into contact with the conjunctiva:

Chlamydial conjunctivitis is not only a disease of newborns. This pathology also affects adults through contact and household spread of the pathogen.

Clinic

Chlamydia of the eye occurs in two main forms: trachoma and paratrachoma (conjunctivitis). The difference between these pathologies lies in the degree of spread of the pathological process, damage to the cornea and the occurrence of changes in it leading to blindness. The described symptoms occur with trachoma. Inflammation of the eye mucosa, fortunately, does not lead to disability.

• With trachoma, inflammation from the conjunctiva spreads to the cornea and is accompanied by the appearance of infiltrates in the latter with a network of ingrown vessels. The cornea thickens and becomes cloudy. After the inflammation subsides, the foci of infiltration are replaced connective tissue. In their place, a scar appears, interfering with vision.

The symptoms of trachoma are quite specific. Thus, a characteristic clouding of the cornea, starting from its upper segment and then spreading downwards, is called pannus (“curtain”). It becomes the cause of vision deterioration as the disease progresses.

Trachoma is a chronic infection eye caused by chlamydia

There are mild forms of the disease that have a favorable outcome. However, more often trachoma leads to serious complications: abnormal eyelash growth, eyelid deformation, sclerosis tear ducts and drying of the cornea, loss of vision.

• Conjunctivitis has no such severe consequences However, symptoms of inflammation of the mucous membrane of the eye significantly reduce the quality of life. These include redness and swelling of the eyelids, granularity of the mucous membrane (due to the appearance inflammatory infiltrates), discharge from the eyes. The discharge is usually scanty; in young children it is profuse and purulent. Foci of inflammation may occur on the cornea, but without ingrowth of blood vessels and scarring, as with trachoma. Other characteristic symptoms: gluing of the eyelids with exudate accumulated overnight, sensation foreign body in the eye.

Trachoma often leads to loss of vision and disability of the patient. Conjunctivitis is not accompanied by the development of blindness, but is difficult to treat, so symptoms persist for a long time.

Diagnostics

Signs of inflammation of the mucous membrane of the eye during chlamydial infection are nonspecific and differ little from those of others bacterial conjunctivitis. Therefore alone clinical symptoms not enough to confirm the diagnosis. Required condition is the detection of the pathogen.

Of particular importance in the diagnosis of chlamydial conjunctivitis is given laboratory tests scraping from the conjunctiva

The gold standard for diagnosis is culture. The material taken for analysis is placed on a cell culture serving nutrient medium. Here the pathogen begins to actively multiply and is detected by other research methods.

Serological diagnosis (detection of antibodies to chlamydia in the patient’s blood) is not always informative. This may be due to insufficient stimulation of the immune system. However, a long-term infection, especially one with complications, still makes it possible to identify specific antibodies.

The screening diagnostic method is PCR. Its advantages include speed of results, high specificity and reliability, and the ability to identify asymptomatic forms of the disease.

Chlamydia of the eye is usually diagnosed based on data obtained by several research methods, as well as clinical manifestations diseases.

Treatment of chlamydial conjunctivitis is usually associated with difficulties, the causes of which are:

• Intracellular localization of the pathogen, which makes it inaccessible to most antibacterial drugs.
• Unsystematic use of antibiotics, resulting in the emergence of treatment-resistant forms of chlamydia.

Chlamydial conjunctivitis is treated with antibiotics

Macrolides, tetracyclines, and fluoroquinolones have activity against Chlamydia trachomatis. Treatment of chlamydial conjunctivitis involves the use of local and systemic therapy:

• Eubetal and colbiocin - combined antibacterial drugs, available in the form of drops and ointments. They contain several antibiotics: chloramphenicol, tetracycline and colistin. For treatment, you can use drops simultaneously (one or two 3-4 times during the day) and ointment (apply at night).
• Okacin (lomefloxacin) is an antibiotic from the fluoroquinolone group. Treatment with this drug is carried out for 7-9 days, drops are instilled 2-3 times a day.
• Antiseptic picloxidine. Prescribed 1 drop 2 to 6 times during the day.
• In the absence of effect, local treatment is supplemented with the use of systemic antibiotics (erythromycin 0.5 g four times a day for 1 week, tetracycline 0.4 g four times a day for 7-10 days, lomefloxacin 0.4 g twice a day for for 10 days).

Long-term use of drugs local action may inhibit tear production. To eliminate this unpleasant effect, tear replacement therapy (oftagel, lacrisify) is prescribed.

Prevention of chlamydial conjunctivitis includes measures to prevent infection with the urogenital form of this disease (avoid promiscuity, use a condom), identifying and treating patients with chlamydia, as well as observing personal hygiene rules.