Evaluation of Patients with Dry Eye Disease for Conjunctival Chlamydia trachomatis and Ureaplasma urealyticum

Aim: To determine the possibility of the development of dry eye disease (DED) as a result of persistent infection with Chlamydia trachomatis and Ureaplasma urealyticum in the conjunctiva of patients. Methods: This study was conducted on 58 patients aged 20-50 years, diagnosed with DED. The diagnosis was confirmed by Schirmer I test and tear breakup time. Control subjects included 27 non-dry eye individuals of the same age range. Ocular specimens were collected as conjunctival scrapings and swabs divided into three samples: the first used for bacterial culture, the second and third for detecting Chlamydia trachomatis and Ureaplasma urealyticum by Direct Fluorescent Antibody (DFA) assay and Polymerase Chain Reaction (PCR) method. Results: Chlamydia trachomatis was detected in 65.5% and 76% of DED patients by DFA and PCR methods, respectively. Ureaplasma urealyticum was found in 44.8% of DED patients using the PCR method. Both organisms were identified in 37.9% of DED patients. Control subjects had a 22% detection rate of Chlamydia trachomatis by DFA assay and a 7% detection rate by PCR; Ureaplasma urealyticum was detected in 3.7% of the controls by PCR. Conjunctival culture revealed that gram-positive microorganisms represented 75% of isolates, with coagulase-negative Staphylococcus (CONS) being the most common (50%), followed by Staphylococcus aureus (20%), whereas gram-negative microorganisms accounted for 25% of cases, with Moraxella spp. as the most frequent organism.