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Sexually Transmitted Disease and Eye Infections

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Author: Dr. Jay Stockman

Chlamydia is a sexually transmitted, urogenital disease that frequently goes un or misdiagnosed. As a result of this under diagnosing many individuals suffer from Adult Inclusion Conjunctivitis(A.I.C.). The reason for the misdiagnosing is the lack of desire by many eye doctors to raise the sensitive subject of sexually transmitted diseases. Often, these individuals may be reluctant to be forthright about their sexual encounters since they are extramarital in nature.

A.I.C. is caused by the bacteria Chlamydia trachomatis, and is the most common cause of persistent conjunctivitis. According to recent studies, 54% of males and 74% of females have A.I.C. secondary to a Chlamydia infection. According to a study done in 1996, Chlamydia is the leading cause of preventable blindness worldwide.

According to the Centers of Disease Control, CDC, Chlamydia is the most common sexually transmitted disease in the US, and is estimated to affect approximately 3 million Americans per year. This gram negative microorganism often presents with few, or no symptoms, and may lie dormant for many months or years. While the most commonly affected age group is 16-34, it can be seen in the young and old alike. The common denominator is being sexually active according to Dr. Jay Stockman a practicing eye doctor in NYC.

Most individuals will present to their eye care provider with a red eye and discharge which looks like any garden variety bacterial conjunctivitis. The doctor will prescribe a topical ocular antibiotic, and a week later the eye will appear normal. This may have presented in one eye, but often seems to spread to the other eye. Then one to three weeks later the patient returns to the eye doctor with a recurrence of the condition. What separates this conjunctivitis from many other types is the presence of follicles, or little bumps in the lower area of the conjunctiva called the palpebral conjuctiva. A culture should always be done which confirms the diagnosis. In addition, frequently there will be swelling of some of the lymph nodes; such as the ones in front of the ears or under the chin.

Confirming the diagnosis is accomplished through following the follicles, cultures and conjunctival scrapings. Treatment includes oral Doxycycline which must be continued until there is full remediation of the conjunctival follicles; which may take several weeks. In certain situations such as pregnancy, a single does of Azithromycin is an affective treatment.

In short, conjunctivitis is often caused by Chlamydia which is a sexually transmitted bacteria. Patients must be honest with their eye doctors when asked about their history since untreated Chlamydial infections can be sight threatening.


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