Chlamydial Conjunctivitis What Is an Eye Infection Caused by Chlamydia?

Many people experience red, irritated eyes or persistent discharge and assume it’s just a common eye infection or allergy. However, these symptoms can sometimes be caused by a sexually transmitted bacterium known as Chlamydia.

When this bacterium infects the eyes, it leads to a condition called Chlamydial conjunctivitis, an inflammation of the conjunctiva that can affect both adults and newborns. The infection usually occurs through contact with contaminated secretions or transmission from mother to baby during childbirth.

Because its symptoms often mimic regular conjunctivitis, this condition is frequently overlooked or misdiagnosed. Without proper treatment, it can cause chronic inflammation or even corneal damage. Understanding its signs, causes, and treatment options is essential for maintaining healthy vision and preventing complications.

What Is Chlamydial Conjunctivitis

Chlamydial conjunctivitis, also known as eye infection caused by Chlamydia trachomatis, is a bacterial infection of the conjunctiva — the thin membrane covering the white part of the eye. It is caused by the same bacterium responsible for sexually transmitted chlamydial infections
and can affect both adults and newborns, especially those exposed through unprotected sexual contact.

Common symptoms include red, swollen eyes with sticky discharge and persistent irritation. Because it often resembles viral or allergic conjunctivitis, many cases go undiagnosed for weeks. If left untreated, the infection may become chronic and lead to inflammation of the cornea.

Transmission occurs through direct contact with infected secretions or contaminated hands and towels. In newborns, the infection can pass from mother to baby during childbirth. Early diagnosis and antibiotic treatment prescribed by a qualified physician can effectively cure the condition.

Causes and Transmission of Chlamydial Conjunctivitis

Chlamydia trachomatis is a bacterium that causes inflammation of the conjunctiva. The infection usually spreads through contact with infected secretions, such as tears or genital fluids, which may reach the eyes via contaminated hands.

In adults, transmission often occurs through direct sexual contact or by touching the eyes after sexual activity without proper hand hygiene. In newborns, the infection can be passed from mother to baby during childbirth when the infant’s eyes come into contact with infected vaginal secretions.

Indirect transmission may also occur through sharing personal items such as towels or face cloths with an infected person. Maintaining good hygiene and avoiding touching the eyes with unwashed hands are key preventive measures to reduce the risk of infection.

Symptoms of Chlamydial Conjunctivitis

Chlamydial conjunctivitis often begins with redness, swelling, and irritation of the eyes, closely resembling common conjunctivitis. Patients usually notice thick, sticky discharge— yellow or white—especially upon waking in the morning. Some may experience itching or a persistent sensation of grit in the eye.

In chronic cases, the inner eyelid may develop small bumps (follicles) and become thickened. If left untreated, inflammation can spread to the cornea, causing blurred vision or eye pain. In newborns, symptoms typically appear 1–2 weeks after birth, characterized by swollen eyelids and thick mucous discharge around the eyes.

Diagnosis of Chlamydial Conjunctivitis

Diagnosing Chlamydial conjunctivitis requires examination by an ophthalmologist or a specialist in sexually transmitted infections. The doctor will begin by reviewing the patient’s symptoms, duration of illness, and potential exposure risks, followed by an eye examination to identify inflammation and characteristic follicles on the inner surface of the eyelid.

Laboratory confirmation is usually done using NAAT or PCR testing to detect Chlamydia trachomatis DNA from conjunctival swabs, with accuracy exceeding 95%. In some cases, Giemsa staining may be performed to visualize infected cells under a microscope.

Accurate and timely diagnosis is crucial for selecting the proper antibiotic treatment, especially in patients with chronic or treatment-resistant eye infections.

Treatment of Chlamydial Conjunctivitis

Chlamydial conjunctivitis is effectively treated with targeted antibiotics to eliminate Chlamydia trachomatis from both the eye and the body. According to 2025 treatment guidelines, Azithromycin (single oral dose) or Doxycycline (7-day course) are the first-line therapies prescribed by physicians.

For newborns, Erythromycin syrup is recommended as a safe and effective option. Topical antibiotic eye drops may be used in combination when significant inflammation is present. Treating both the patient and their sexual partner is essential to prevent reinfection.

Patients should avoid using steroid-containing eye drops without medical advice and attend follow-up visits to ensure the infection has completely cleared and to prevent chronic inflammation or recurrence.

Complications of Untreated Chlamydial Conjunctivitis

If Chlamydial conjunctivitis is left untreated, inflammation of the conjunctiva can spread to the cornea, leading to keratitis, which may cause blurred vision or long-term visual impairment.

Some patients develop thickened conjunctiva or scarring of the inner eyelid, which can result in inward-turning eyelashes (trichiasis) that repeatedly scratch the cornea, causing secondary infections or chronic irritation.

In newborns, untreated infection may extend beyond the eyes and cause respiratory infections or pneumonia. Early diagnosis and proper antibiotic therapy are crucial to prevent vision loss and reduce the risk of transmission to others.

Prevention and Self-Care for Chlamydial Conjunctivitis

Preventing Chlamydial conjunctivitis starts with good personal hygiene. Avoid touching the eyes with unwashed hands and never share personal items such as towels or face cloths, which may carry infectious bacteria.

Safe sexual practices are essential, as Chlamydia trachomatis can spread from the genitals to the eyes through direct contact. Always use condoms and undergo regular STI screenings, especially for those with multiple sexual partners.

Pregnant women should be screened for chlamydial infection during prenatal checkups to reduce the risk of passing the infection to their baby during delivery. If infection is detected, prompt medical treatment helps prevent complications for both the mother and the newborn.

Chlamydial Conjunctivitis in Adults vs Newborns

Chlamydial conjunctivitis affects both adults and newborns, but the causes and clinical features differ significantly. In adults, infection usually occurs through direct contact with genital secretions during sexual activity or by touching the eyes with contaminated hands afterward.

In newborns, transmission happens when Chlamydia trachomatis is passed from an infected mother during childbirth. Symptoms typically appear within 5–14 days after birth and include swollen, red eyelids with thick mucous discharge.

Treatment also varies by age group. Adults are treated with oral antibiotics such as Azithromycin or Doxycycline, while newborns are prescribed Erythromycin syrup, a milder antibiotic proven safe and effective under medical supervision.

When to See a Doctor

You should see a doctor if redness, swelling, or sticky eye discharge persists for more than a week or does not improve with standard eye drops, especially if you have had unprotected sexual contact.

For newborns, medical attention is needed immediately if eye discharge or eyelid swelling occurs within two weeks after birth, as it may indicate infection with Chlamydia trachomatis. Prompt treatment by a qualified specialist can prevent corneal complications and protect long-term vision.

Residents in Bangkok and nearby areas can visit Safe Clinic for professional diagnosis and treatment by experienced ophthalmologists and STI specialists.

Frequently Asked Questions about Chlamydial Conjunctivitis

1. Can chlamydial conjunctivitis be cured?
   Yes. It can be effectively treated with proper antibiotics prescribed by a doctor, such as Azithromycin or Doxycycline for adults, and Erythromycin syrup for newborns. Avoid self-medicating, as it may cause antibiotic resistance.
2. How is the infection transmitted?
   Chlamydia trachomatis spreads through contact with infected secretions such as tears or genital fluids, and can also be passed from mother to baby during childbirth.
3. Is it dangerous?
   If left untreated, it may cause chronic conjunctivitis, corneal inflammation, or scarring inside the eyelid. With timely treatment, full recovery is expected without long-term vision problems.
4. Will regular eye drops cure it?
   No. Standard eye drops only relieve irritation temporarily. Specific antibiotics are required to eliminate the bacteria completely.
5. Where can I get tested and treated in Bangkok?
   You can visit Safe Clinic, where ophthalmologists and STI specialists provide accurate testing and complete treatment.

Conclusion

Chlamydial conjunctivitis may start as a simple red eye, but without proper diagnosis and treatment, it can progress and affect vision. Early medical evaluation is the key to effective care and faster recovery.

If you experience persistent red eyes, swelling, or thick discharge, or suspect possible infection from sexual contact, you should consult a specialist for accurate testing and targeted antibiotic treatment.

At Safe Clinic, our experienced ophthalmologists and STI specialists provide confidential consultations, accurate diagnostics, and safe, evidence-based treatment.

Reference

1. World Health Organization (WHO) — “Trachoma” (Chlamydia trachomatis)
2. Centers for Disease Control and Prevention (CDC) — STI Treatment Guidelines: Chlamydial Infections
3. Clinical guideline — College of Optometrists: “Conjunctivitis, chlamydial (Adult inclusion conjunctivitis)”
4. Review article — “Trachoma | Nature Reviews Disease Primers”
5. Textbook reference — “Trachoma | Merck Manual Professional Edition”

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