About 20 months ago I visited a massage parlour. After the massage I was offered brief oral which I stopped.. She then masturbated me while I fingered her vagina for a few minutes before ejaculating. I did a gonorrhoea and chlymidia test 4 weeks after before resuming protected  relations with my wife. I did a full STI blood test about a year ago. Both were negative I have only had protected vaginal sex in time since although on 3-4 occasions i have given my wife oral sex. I have had an issue with my eye watering probably 3-4 weeks after the massage visit. I went to an optometrist in weeks after and tried a bacterial ointment but has persisted although quite mild. Waters far more in colder weather and wind.. My wife has also had on off eye issues over last year but has got worse since we have been on holiday and watering quite significantly and really irritating her.  She’s taken various ointments but hasn’t got better. I only read about eye chlymidia. is it possible that I have contracted in my eye (through perhaps not washing my hands after fingering] and passed on to her through eye to eye transmission. As above I am negative for genital chylmidia.

Chlamydial conjunctivitis (eye infection) is rare; in my 40+ years in the STD business, I have personally seen exactly one case. The typical symptoms and signs are irritation and redness, but there has never been a report of it lasting more than a few weeks. The immune system clears genital chlamydia within a few weeks or months. There are too few eye infections to allow study of how long such infections might last, but there is no reason to suppose they persist any longer than genital infection does. And while in principle chlamydial conjunctivitis could occur in absence of genital infection, that has never been reported to have actually happened.

Finally, although I am not an expert in ocular symptoms, my understanding is that symptoms like yours are quite common, usually due to chemical irritation or allergy. The symptoms you describe strike me as quite typical for a non-infectious problem like allergy or other physical irritation.

For all those reasons, I cannot imagine you or your wife has an ocular chlamydial infection. For further reassurance, you might discuss the situation with your optometrist. If s/he believes your symptoms ARE consistent with a chlamydial infection, it would be a simple matter to do a chlamydia swab test from your eyes. If that's done, I am confident the result would be negative.

I hope these comments are helpful. Let me know if anything isn't clear.

HHH, MD

My wife is planning to see an ophthalmologist who of course will run tests and diagnose but I’m obviously anxious about the potential of my previous actions being detected which I do have guilt about and the impact on my relationship. These will be my final questions so once again thank you for your time and advice.

I am unaware of the data you cite, in particular that ocular involvement is present in 1 in 300 cases of chlamydial infection. That certainly doesn't fit with my clinical experience: see my comment above about the single patient I've seen in my 50 years in the STD business. I also have a hard time believing that it doesn't resolve in the absence of treatment:  chlamydia of all other anatomic cites (urethra, cervix, rectum, throat) clears up without treatment after varying intervals -- typically a few weeks to month, on average longer for the cervix than urethra, and a lot sooner for pharyngeal (throat) infection. I'd be surprised if ocular infection is remarkably different.

As these uncertainties imply, there are few data available in general, and I have no idea what level of eye exposure would be necessary to establish infection. Given that almost all humans rub their eyes quite frequently, and the fingers of persons with genital chlamydia must be contaminated with the organism some of the time, I would assume the transmission risk is low and that it takes substantial exposure to establish an ocular infection.

In any case, conjunctivitis (superficial eye inflammation) is very common and I'm confident that chlamydia is a rare cause. I would also add that the exposure that you describe 20 months ago carried little or no risk of chlamydia, and I cannot imagine that chlamydia explains your wife's problem. However, the only way to know would be to take a chlamydia test from her eye(s); simple examination without testing rarely would identify chlamydia and chlamydia testing almost certainly is done rarely by most ophthalmologists. Your wife's doctor will need a heads-up to know to do the test. If done, you should expect a negative result.

Sorry again for the delay in this reply. I'll be interested to know the outcome if she is tested, so I'll leave this thread open for one more follow-up comment after that's been done.