Incidence and clinical presentation of chlamydial keratoconjunctivitis: a preliminary study.

Using a direct immunofluorescent technique and monoclonal antibody, chlamydia trachomatis was detected in the conjunctival smears of 13 out of 47 patients presenting with conjunctivitis or keratoconjunctivitis (an incidence of 28%). Two patients presented with acute symptoms of few days duration, whereas the condition was chronic and of long duration in 11 patients. Conjunctival changes noted were upper and lower palpebral conjunctival follicles and papillae (11 patients), chemosis (5 patients), upper tarsal scar (2 patients) and pseudomembrane (one patient). Corneal involvement was detected in 9 patients and was manifested as micropannus (6 patients), multiple small epithelial punctate stains (3 patients), extensive pannus affecting the upper third of the cornea (2 patients), subepithelial punctate infiltrates similar to that of adenovirus infection (2 patients) and upper limbal follicles (one patient). Identification of chlamydia trachomatis in conjunctival smears by use of the monoclonal antibody is a simple, rapid and reliable laboratory procedure.