[Question #4487] Pink Eye - Chlamydia

81 months ago

Hello.

Just over 3 years ago I had a one night stand with a stranger in the UK, I was tested 4 days later for all STI and results came back negative, Prior to results I took Azithromycin as a precaution. Over the past 2 months I have been suffering from Pink Eye, 2 sets of antibiotic drops did not work. More recently I was given Predniosolone Steroid drops, these seemed to work and I stopped taking them 10 days ago. Today the pink eye is back.

The ophthalmologist said pink eye could be caused by Chlamydia at the first appointment however they did not test for same. I have been in a monogamous relationship for the last 3+ years.

My questions are:-

1 Could this outbreak of pink eye have been caused by the episode 3 years ago?

2 Can you catch pink eye caused by chlamydia any other way than sexual exposures.

Thanks

Edward W. Hook M.D.

81 months ago

Welcome to the Forum. While chlamydial infections can cause conjunctivitis and pink eyes, there is little risk that this is occurring for you. Chlamydia infections caused by a different, non-STI strain of chlamydia are a leading cause of blindness in developing nations causing the disease "trachoma", primarily in children. Trachoma is caused by transfer of chlamydia from person to person on the feet of flies that actually land on people's eyes. It is extraordinarily rare in North America and Western Europe. In addition, very rarely, children born to infected mothers acquired chlamydia when they are born with delivery through an infected birth canal. Finally, rarely, chlamydial eye infections may occur following "golden showers" in which sex partners urinate on a partners face (and eyes). I presume none of these circumstances apply to you. In your case:

1. the risk for acquiring any STI following a single exposure is low.

2. Presumably there was no direct exposure to your eye during your dalliance.

3. You did not have symptoms that you reported.

4. You were tested and the tests were negative

5. The azithromycin you took would have cured chlamydia if you had gotten it (Azithromycin is also recommended treatment for trachoma).

6. Most untreated chlamydial infections would have cured themselves within a year of acquiring them, its been too years for you.

From what you tell me, there is little reason to worry about chlamydia causing your conjunctivitis. Viruses are the most common cause. If the infection has not resolved with therapy you should work with an ophthalmologist to determine what is causing it and the best management but I would not worry that this is an STI acquired form a single exposure two years ago.

I hope this perspective is helpful. EWH

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81 months ago

Thanks for your quick response, the only area of concern then (as there was no direct exposure to my eye 3 years ago) is that I have just returned from holiday in Thailand. no exposures) however you mention Trachoma outside of US & Western Europe -

1 Would Thailand be an area at risk from this?

2 If so would you recommend Azithromycin as a pre-caution?

Thanks again

Paul

Edward W. Hook M.D.

81 months ago

1. No risk. If flies had been crawling on your eyes, you would know it.

2. No, we recommend against precautionary antibiotics. In all too many cases, they just make finding out what is really going on more difficult. As I said above, I suggest you work with your ophthalmologist to find out what is really going on. EWH

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81 months ago

Thanks again, final question due to anxiety.

Could you have no conjunctivitis symptoms for over 3 years and then all of a sudden get them. Most sites I have read say chlamydia conjunctivitis symptoms appear 1-3 weeks post exposure.

Edward W. Hook M.D.

81 months ago

The sites you have looked at are in the right ball park. Chlamydial conjunctivitis would have become symptomatic within 2-3 weeks of exposure, not after a matter of years.

As your note implies, this will be my last response to your questions. Our site providers up to three responses per question thread. This is my 3rd response. The thread will be closed shortly without further answers. Please don't worry. EWH

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