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September 18, 1981

Ocular Chlamydial Infections

Author Affiliations

Bedford, Tex

JAMA. 1981;246(12):1301-1302. doi:10.1001/jama.1981.03320120013012

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To the Editor.—  The excellent article by King K. Holmes, MD, PhD, "The Chlamydia Epidemic" (1981;245:1718), corroborates what I have long suspected. As an ophthalmologist, I find adult inclusion conjunctivitis is not at all rare if one's suspicion is high. While in training at a county hospital I saw it often and continue to see it even in private practice. Clinical features are a follicular conjunctival reaction with mucoid discharge, and sometimes peripheral corneal vascularization or keratitis (corneal erosions). The diagnosis can be confirmed by a Giemsa stain of a conjunctival scraping; in adults the inclusions typically are not seen in epithelial cells, but the distinctive presence of polymorphonuclear cells and particularly plasma cells (in the presence of the clinical follicular reaction) substantiates the diagnosis. A standard adult treatment is 500 mg of tetracycline, three times a day for three weeks.My main problem has been explaining the transmission of