title: A systematic approach to the diagnosis and treatment of chronic conjunctivitis.
abstract: In 58 patients with chronic conjunctivitis of greater than two weeks' duration, examination included obtaining an ocular and general medical history and performing a complete ophthalmic examination of the external eye. Conjunctival smears were obtained for Gram and Giemsa staining, direct immunofluorescent monoclonal antibody staining for Chlamydia trachomatis and herpes simplex virus, and chlamydial culture. Cultures for bacteria and viruses were obtained in 33 patients. The cause of the chronic conjunctivitis based on clinical and laboratory criteria was established in 40 of 58 (69%) patients: chlamydia, 11 (19%); virus, eight (14%); irritant, six (10%); allergen, four (7%); contact lens, four (7%); bacteria, four (7%); acne rosacea, two (3%); and floppy eyelid syndrome, one (2%). In 18 of 58 (31%) patients, no specific cause was detected. We recommend a systematic approach in the investigation of chronic conjunctivitis. Direct immunofluorescent monoclonal antibody staining is an effective and rapid technique for detecting chronic chlamydial conjunctivitis.
authors.affiliation: Department of Ophthalmology, University of Wisconsin-Madison 53792.
authors.forename: P A
authors.initials: PA
authors.lastname: Rapoza
authors.forename: T C
authors.initials: TC
authors.lastname: Quinn
authors.forename: A C
authors.initials: AC
authors.lastname: Terry
authors.forename: J D
authors.initials: JD
authors.lastname: Gottsch
authors.forename: L A
authors.initials: LA
authors.lastname: Kiessling
authors.forename: H R
authors.initials: HR
authors.lastname: Taylor
mesh_terms: D000328:Adult; D000485:Allergens / Q000276:immunology; D000911:Antibodies, Monoclonal; D002690:Chlamydia Infections / Q000150:complications / Q000175:diagnosis; D002692:Chlamydia trachomatis / Q000276:immunology / Q000302:isolation & purification; D002908:Chronic Disease; D003231:Conjunctivitis / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D003261:Contact Lenses / Q000009:adverse effects; D004205:Cromolyn Sodium / Q000627:therapeutic use; D005069:Evaluation Studies as Topic; D005260:Female; D005455:Fluorescent Antibody Technique; D005469:Fluorometholone / Q000627:therapeutic use; D006801:Humans; D007635:Keratitis, Dendritic / Q000150:complications / Q000175:diagnosis; D008297:Male; D011446:Prospective Studies; D018139:Simplexvirus / Q000276:immunology / Q000302:isolation & purification; D013203:Staphylococcal Infections / Q000150:complications / Q000175:diagnosis; D013212:Staphylococcus epidermidis; D013752:Tetracycline / Q000627:therapeutic use
chemical_list: D000485:Allergens; D000911:Antibodies, Monoclonal; D013752:Tetracycline; D004205:Cromolyn Sodium; D005469:Fluorometholone