Chlamydial conjunctivitis is a bacterial infection that causes eye inflammation. It results from hand-to-eye contact after contact with the bacteria that causes genital chlamydia infections. Symptoms include itching and a watery discharge from the eyes.

Sexually active people are at risk of coming in contact with chlamydia, a type of sexually transmitted infection (STI).

A person can develop an asymptomatic infection on the genitals and spread it to their eyes through contact with the hands.

This article reviews what chlamydial conjunctivitis is, including its symptoms, causes, treatments, and more.

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Chlamydial conjunctivitis, or adult inclusion conjunctivitis, is a bacterial infection. It makes up 1.8% to 5.6% of all acute conjunctivitis cases.

It is most common in young, sexually active adults, but it can affect anyone who is sexually active.

The bacteria spreads through hand-to-eye contact after touching the genital secretions of someone with a chlamydia infection.

Newborn infants can also contract it during delivery if the birth parent has chlamydia. When this happens, healthcare professionals refer to it as chlamydial ophthalmia neonatorum. It typically develops within 1–4 weeks of birth.

It often affects one eye, but the infection can affect both.

There are several different types of Chlamydia trachomatis, the bacteria responsible for chlamydia. They include serotypes A–C, which can lead to trachoma, a leading cause of blindness worldwide, and serotypes D–K, which are responsible for both ophthalmia neonatorum and adult inclusion conjunctivitis.

What other STIs can affect the eyes?

The Centers for Disease Control and Prevention (CDC) note that alongside chlamydia, gonorrhea can also cause conjunctivitis.

Symptoms of chlamydial conjunctivitis can take 2–19 days to appear. People who develop the infection may experience symptoms that can include:

  • watery discharge or pus
  • itchy, red, swollen, or scratchy eyes
  • sensitivity to light

However, it does not typically cause pain.

A person with chlamydial conjunctivitis will likely have a chlamydia genital infection, which causes the following symptoms in females:

  • pain during urination
  • pelvic or abdominal pain
  • unusual vaginal discharge
  • pain during intercourse
  • bleeding after intercourse
  • bleeding between periods

Males may experience:

  • pain during urination
  • testicle pain
  • burning or itching in the urethra
  • penile discharge that is white, watery, or cloudy

In infants

Babies with the condition typically experience symptoms 5–14 days after birth. However, symptoms may develop sooner if the amniotic sac ruptures during delivery.

Symptoms in babies include:

  • watery or bloody discharge from the eyes
  • eyelid swelling
  • eye redness

They may also develop a pseudomembrane. This is a membrane in the eye that develops as a result of infections and inflammation. It usually covers the white parts of the eyes.

Chlamydial conjunctivitis develops due to the bacteria called Chlamydia trachomatis with serotypes D–K. A person can contract the bacteria via sexual contact.

People typically develop chlamydial conjunctivitis through hand-to-eye contact following contact with the genital secretions of someone with chlamydia.

A person can also contract it by sharing items such as:

  • false eyelashes
  • washcloths
  • towels
  • other cosmetics

In rare cases, people can acquire it when swimming in a contaminated pool.

Chlamydia typically spreads in teens and adults that are sexually active and between the ages of 15 and 35 years old.

Risk factors can include:

  • having multiple sexual partners
  • engaging in sex without using a barrier method
  • having a sexual partner who is asymptomatic
  • not washing hands following sexual contact

Typically, those with chlamydial conjunctivitis have had a new sexual partner 2 months prior.

Treatment and management involve treating the chlamydial infection and managing the symptoms.

In adults, a doctor will typically prescribe one of the following oral antibiotics:

  • Azithromycin: A person can take 1 gram in a single dose.
  • Doxycycline: An individual can take 100 milligrams (mg) twice daily for 1 week.
  • Erythromycin: A person can take 500 mg four times daily for 1 week.

A person’s sexual partners will also require treatment.

To help with symptoms, a doctor may recommend that people avoid wearing contacts and use ointments or eye drops to help lubricate the eyes.

For infants, a doctor will also prescribe oral antibiotics.

The United Kingdom’s National Health Service (NHS) states that eye inflammation from a chlamydial infection will persist until a person starts treatment.

However, once treatment begins, the eye inflammation should settle quickly and should not result in any lasting damage to a person’s vision.

To diagnose chlamydial conjunctivitis, a doctor will likely conduct a physical exam, review medical history, and talk about a person’s symptoms and recent activities.

A doctor may also swab the eye and send a sample to a lab to test for the bacteria, although many healthcare professionals may not need this test. They may also recommend testing the person for other STIs.

To help prevent chlamydial conjunctivitis, a person and their sexual partners should receive regular testing for STIs.

People should also wash their hands following sexual contact before touching the eyes and face.

In infants, many states have laws that require healthcare professionals to apply eye drops or ointment into the eyes of newborns within 2–3 hours of birth.

A person should contact a doctor if they experience symptoms of chlamydial conjunctivitis, particularly if:

  • they have had sexual intercourse without using a barrier protection
  • they have a new sexual partner
  • they have multiple partners

People who are pregnant should undergo screenings to check for STIs.

Chlamydial conjunctivitis occurs when the bacteria associated with genital chlamydia infections come into contact with the eyes.

The infection often spreads from a person’s hand touching the genitals and then touching the eyes.

Treatment involves a combination of antibiotics and drops to help clear up the infection and manage symptoms. Following treatment, a person should fully recover.