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There is no doubt that the mass, community-wide distribution of azithromycin has been shown to be effective in reducing the prevalence of ocular chlamydial infection in various populations. It is likely that mass treatments will continue and that there will be requirement for repeated treatments. Potential disadvantages of this therapy include allergic or other reactions and the selection and propagation of macrolide resistant bacteria in treated populations. Gaynor and colleagues report a study of children in western Nepal who were treated with azithromycin. In their study the authors did not find that azithromycin therapy induced antibiotic resistance to Streptococcus pneumoniae. See p 147
Visual field testing is an essential part of the ophthalmic examination. The validity of the information obtained from this test depends on the ability of the patient to reliably perform it. Some studies have suggested that a significant number of patients are unable to perform this
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