chronic follicular conjunctivitis

Chronic Follicular Conjunctivitis: A Persistent Eye Infection

Chronic follicular conjunctivitis is a type of eye infection that lasts longer than usual, typically exceeding 3 months in duration. This condition is characterized by the presence of lymphoid follicles in the conjunctiva, which can cause inflammation and discomfort.

Causes and Types

The most common cause of chronic follicular conjunctivitis is an infection with Chlamydia trachomatis subtypes A through C [13]. Other types of chronic follicular conjunctivitis include:

• Toxic follicular conjunctivitis: a toxic reaction to a specific topical medication
• Chronic cicatrizing conjunctivitis: caused by a toxic medicamentosa reaction or ocular cicatricial pemphigoid

Symptoms

The symptoms of chronic follicular conjunctivitis can include:

• Persistent redness and irritation in the eye
• Grittiness, burning, or foreign-body sensation
• Photophobia (sensitivity to light)
• Scarring of the inner eyelid, which can cause the eyelashes to turn in and scratch the cornea (trichiasis)

Treatment

Chronic follicular conjunctivitis requires prolonged treatment, and scarring of the conjunctiva is a rare but possible complication [15]. Treatment may involve antibiotics or antiviral medications, depending on the underlying cause.

Prevention

While there is no specific way to prevent chronic follicular conjunctivitis, practicing good hygiene and avoiding close contact with individuals who have the infection can help reduce the risk of transmission.

Symptoms of Chronic Follicular Conjunctivitis

Chronic follicular conjunctivitis can manifest in various ways, depending on the underlying cause. Here are some common signs and symptoms:

• Redness: The eyes appear red or bloodshot due to inflammation [12].
• Itching and irritation: Patients may experience itching and irritation in the affected eye(s) [13].
• Watery or mucous discharge: A watery or mucous-like discharge may be present, especially during the active stage of follicular conjunctivitis [10].
• Mature or large-sized follicles: In the active stage, mature or large-sized follicles can be visible to the naked eye, indicating a chronic infection [10].

Additional Symptoms

Other symptoms that may accompany chronic follicular conjunctivitis include:

• Conjunctival hyperemia: The conjunctiva may appear red and inflamed.
• Pain: Some patients may experience pain or discomfort in the affected eye(s).
• Vision problems: In severe cases, chronic follicular conjunctivitis can lead to vision problems or even blindness if left untreated.

Causes of Chronic Follicular Conjunctivitis

Chronic follicular conjunctivitis can be caused by various factors, including:

• Infections: Bacterial, viral, or fungal infections can cause chronic follicular conjunctivitis.
• Medication reactions: Toxic reactions to certain medications can lead to chronic follicular conjunctivitis [9].
• Autoimmune disorders: In some cases, chronic follicular conjunctivitis may be a symptom of an underlying autoimmune disorder.

It's essential to consult a healthcare professional for proper diagnosis and treatment of chronic follicular conjunctivitis.

Diagnostic Tests for Chronic Follicular Conjunctivitis

Chronic follicular conjunctivitis requires a thorough diagnostic workup to identify the underlying cause and develop an effective treatment plan. The following tests may be conducted to diagnose this condition:

• Blood tests: To rule out systemic infections or conditions that may be contributing to the conjunctivitis (Context 1).
• Swabbing: A swab of the eye may be taken to test for the presence of bacteria and viruses, such as Chlamydia trachomatis (Contexts 3, 12).
• Clinical examination: A comprehensive eye exam is necessary to diagnose follicular conjunctivitis, including checking under the eyelids for typical signs (Contexts 5, 10).
• Laboratory tests: Depending on the suspected cause, laboratory tests such as immunoperoxidase, electron microscopy, or polymerase chain reaction (PCR) assay may be conducted to confirm the diagnosis (Contexts 6, 14).
• Microbiological tests: In some cases, microbiological tests may be recommended to confirm the cause of the infection (Contexts 7, 10).

Additional Tests

In certain situations, additional tests may be necessary to rule out other conditions that may be masquerading as follicular conjunctivitis. These include:

• Skin testing: To diagnose skin-related causes of chronic follicular conjunctivitis, such as molluscum lesions (Contexts 10, 13).
• Rapid antigen test: To diagnose viral conjunctivitis and avoid inappropriate use of antibiotics (Context 11).

Citations

1. Context 1
2. Contexts 3, 12
3. Contexts 5, 10
4. Contexts 6, 14
5. Contexts 7, 10
6. Contexts 10, 13
7. Context 11

Treatment Options for Chronic Follicular Conjunctivitis

Chronic follicular conjunctivitis requires accurate diagnosis of the underlying cause to determine the most effective treatment approach. Based on the search results, here are some potential treatment options:

• Antibiotics: In cases where bacterial infections such as chlamydia or gonorrhea are suspected, antibiotics like azithromycin (1g single dose) or doxycycline (100mg twice daily for 1-2 weeks) may be prescribed [11].
• Topical corticosteroids and cyclosporin: In some cases, treatment with topical corticosteroids and cyclosporin (CsA) has resulted in inflammation control and allowed for steroid taper without severe complications [12].
• Treatment of underlying systemic conditions: If chronic follicular conjunctivitis is associated with underlying systemic conditions such as glaucoma or molluscum contagiosum, treatment may involve addressing these conditions first.
• Antiviral medications: In cases where viral infections are suspected, antiviral medications may be prescribed.

It's essential to note that the specific treatment approach will depend on the underlying cause of the chronic follicular conjunctivitis and should be determined by a qualified healthcare professional.