Chlamydia Trachomatis Infections: A Hidden Cause of Meibomian Gland Dysfunction

Purpose: Meibomian gland dysfunction (MGD) is a common eye problem, which is asymptomatic in the early stage, but if left untreated for a prolonged period can exacerbate to dry eye syndrome. Role of bacteria in the pathophysiology of MGD is always controversial. This pilot study was undertaken to find the association of Chlamydia trachomatis apart from the normal biota of the eyelid with MGD in a tertiary care hospital in India. Methods: A total of 112 MGD patients with follicular conjunctival inflammation with either of the symptoms such as; Meibomitis (22), Dry eye (42), Watering (19), Blepharitis (9), Chalazion/ Hardoleum (20) were referred to the Chlamydial laboratory for further investigation. Conjunctival swabs of both eyes were subjected to direct immunofluorescence assay (DFA) for C. trachomatis antigen detection. Results: Of the 112 MGD patients, 62 (55.30%) were found positive for C. trachomatis with DFA, out of which 54(87%) had good clinical response for topical azithromycin (1% eye drop), topical lubricants and warm compresses. Conclusions: We concluded from this study that, C. trachomatis is one of the causes for MGD with follicular conjunctival inflammation and topical azithromycin is a good choice for treatment and improving the signs and symptoms of the infection. As the role of chlamydia in MGD is not clear, this study will disclose an exciting fact about the pathophysiology of the disease, which will in turn improve treatment strategy to some extent to combat with the common but frustrating