ADULT INCLUSION CONJUNCTIVITIS
It is a type of acute follicular conjunctivitis associated with mucopurulent discharge.
It usually affects the sexually active young adults.
Etiology
Inclusion conjunctivitis is caused by serotypes D to K of Chlamydia trachomatis.
The primary source of infection is urethritis in males and cervicitis in females.
The transmission of infection may occur to eyes either through contaminated fingers or more commonly through contaminated water of swimming pools (hence the name swimming pool conjunctivitis).
Clinical features
Incubation period of the disease is 4-12 days.
Symptoms
*� Ocular discomfort, foreign body sensation,
* Mild photophobia, and
*� Mucopurulent discharge from the eyes.
Signs of inclusion conjunctivitis are:
*� Conjunctival hyperaemia, more marked in fornices.
*� Acute follicular hypertrophy predominantly of lower palpebral conjunctiva.
*� Superficial keratitis in upper half of cornea.
* Sometimes, superior micropannus may also occur.
*�Pre-auricular lymphadenopathy is a usual finding.
Clinical course.
The disease runs a benign course and often evolves into the chronic follicular conjunctivitis.
Differential diagnosis must be made from other causes of acute follicular conjunctivitis.
Treatment
1. Topical therapy. It consists of tetracycline (1%) eye ointment 4 times a day for 6 weeks.
2. Systemic therapy is very important, since the condition is often associated with an asymptomatic venereal infection. Commonly employed antibiotics are:
� Tetracycline 250 mg four times a day for 3-4 weeks.
� Erythromycin 250 mg four times a day for 3-4. weeks (only when the tetracycline is contraindicated e.g., in pregnant and lactating females).
� Doxycycline 100 mg twice a day for 1-2 weeks or 200 mg weekly for 3 weeks is an effective alternative to tetracycline.
� Azithromycin 1 gm as a single dose is also effective.
Prophylaxis
Improvement in personal hygiene and regular chlorination of swimming pool water will definitely decrease the spread of disease.
Patient's sexual partner should be examined and treated
OPTOMETRY-SHARP VISION
Optometrist