Conjunctival cytology of adult chlamydial conjunctivitis

K. R. Wilhelmus, N. M. Robinson, L. L. Tredici and D. B. Jones

We assessed the diagnostic value of ocular cytologic examination by reviewing Giemsa-stained smears of conjunctival scrapings. Of 387 patients with a clinical diagnosis of adult chlamydial conjunctivitis, intracytoplasmic inclusions were found in 30 (8%). Both polymorphonuclear leukocytes and lymphocytes were common; the predominant cell type was not useful to differentiate chlamydial from adenoviral conjunctivitis. More sensitive cytologic features included the presence of plasma cells, Leber cells, blastoid cells, and multinucleated cells. Giemsa-stained conjunctival cytologic examination can provide a useful method to support the clinical diagnosis and to direct further laboratory testing.