We report the results of conjunctival scrapings done in 234 eyes of 127 patients presenting with acute, chronic, or recurrent conjunctivitis. Although some patients had the classic features of superior pannus, Herbert's pits, conjunctival follicles, and tarsal distortions, others presented in a more subtle fashion mimicking allergic, viral, and bacterial diseases of the eyes. These scrapings were subjected to rapid diagnostic techniques and culture studies for the identification of chlamydial infections. The correlation between the clinical and laboratory diagnosis was studied. Of the 127 patients, 44 were culture positive for Chlamydia. Of these, only 19 had been clinically suspected to have chlamydial ocular disease, whereas the others were diagnosed to have bacterial, viral, allergic, or other diseases. This higher rate of Chlamydia detection is probably a reflection of endemicity of this infection in India. This article highlights the possible underdiagnosis of chlamydial ocular disease in the outpatient department and emphasizes the importance of microbiological evaluation in patients with atypical or chronic ocular surface disease.