Management
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Chlamydial Conjunctivitis
Î Systemic therapy is indicated for chlamydial conjunctivitis. (III, I, D)
Î Empiric antibiotic therapy can be considered in patients with
symptoms and signs highly suggestive of chlamydia. (III, I, D)
Î There are no data to support the use of topical therapy in addition to
systemic therapy. (III, I, D)
Î Patients should be re-evaluated following treatment. (III, G, S)
Î The follow-up visit should consist of an interval history, visual acuity
measurement, and slit-lamp biomicroscopy. (III, I, D)
Î Adult conjunctivitis usually responds to systemic therapy, and sexual
contacts should be treated at the same time. (III, I, D)
Î Patients and sexual contacts should be informed about the possibility
of concomitant disease and should be referred appropriately. (III, G, S)
Î Sexual abuse should be considered in children with this condition.
(III, G, S)
Ocular Mucous Membrane Pemphigoid (OMMP) Conjunctivitis
Î The diagnosis of OMMP is typically one of exclusion, and a
conjunctival biopsy for immunopathology confirms the diagnosis.
(III, I, D)
Î If the patient is using any of the drugs associated with medication-
induced mucous membrane pemphigoid, OMMP should be considered,
and trial discontinuation of the medication should be attempted.
(III, I, D)
Î Grading systems and photographic documentation of the conjunctiva
may be helpful to assess disease progression. (III, I, D)
Î Although topical corticosteroid therapy may aid in controlling acute
conjunctival inflammation, systemic immunosuppressive therapy is
usually required to inhibit inflammation and prevent progression of
conjunctival scarring. (III, I, D)
Î The rate of disease progression, age and general condition of the
patient, and the potential complications of immunosuppressive
therapy should be considered and discussed with the patient before
initiating therapy. (III, I, D)
Î Systemic corticosteroids may be indicated to control inflammation
initially, but they should be weaned as other immunosuppressive
therapy becomes effective to avoid complications of chronic
corticosteroid use. (III, G, S)
