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Chlamydial conjunctivitis will usually go unrecognized and therefore untreated unless it is specifically considered. The possibility of chlamydial infection must be borne in mind in neonatal conjunctivitis, in acute conjunctivitis in sexually active adults, and in chronic follicular conjunctivitis. Chlamydial conjunctivitis is often indistinguishable from other forms of conjunctivitis on clinical grounds, and accurate diagnosis is based on laboratory tests. It seems that direct fluorescent antibody (DFA) cytology offers an attractive alternative to the more complicated and time-consuming tissue culture isolation method. Once diagnosed, chlamydial infection should be treated with the appropriate systemic antibiotics, and proper posttreatment follow-up is necessary to assess the efficacy of treatment.