Limbal disease in trachoma and other ocular chlamydial infections: risk factors for corneal vascularisation.

Ocular infection with Chlamydia trachomatis, whether of genital or endemic trachoma origin, usually produces diffuse infiltration and swelling of the scleral limbus, grey infiltrates of the corneal limbus, and superficial extension of vessels onto the corneal limbus. In genitally transmitted C. trachomatis infections, subepithelial infiltrates have been reported as well. In classic endemic trachoma, limbal changes also include limbal follicles which resolve, leaving Herbert's peripheral pits, and an extensive vascular pannus. To evaluate the limbal changes in trachoma, follow-up studies were done in 1986-1987 in a group of 213 children originally seen between 1969-1972. Pannus formation occurred at a much earlier age than conjunctival scar formation and was an excellent predictor of later severe conjunctival scarring. The evidence from this study suggests that the mechanisms for corneal pannus formation from the limbus are quite different from those for scarring of the conjunctiva.