Inclusion conjunctivitis in a sexually active adult is caused by Chlamydia trachomatis serovars D–K. The characteristic clinical sign on upper tarsal examination that differentiates it from trachoma is:
- A Large follicles predominantly on the lower tarsal conjunctiva, with superior tarsal sparing ✓
- B Presence of superior limbal follicles with Herbert's pits
- C Intense upper tarsal follicular reaction with superior corneal pannus (trachoma pattern)
- D Pseudomembranous reaction on the upper tarsal surface
Explanation
Adult inclusion conjunctivitis (adult chlamydial conjunctivitis) from serovars D–K preferentially involves the inferior tarsal conjunctiva and inferior fornix with large follicles — contrasting with trachoma (serovars A–C) where the pathology is predominantly on the upper tarsal plate with superior limbal involvement (Herbert's pits, superior pannus). Inclusion bodies on Giemsa staining are cytoplasmic within epithelial cells. Treatment is systemic azithromycin (1 g single dose) or doxycycline, with concomitant treatment of the sexual partner for urethritis/cervicitis. Corneal involvement (peripheral subepithelial infiltrates) may occur in adult inclusion conjunctivitis.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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