Which characteristic is NOT typical of chlamydial conjunctivitis?

Chlamydial conjunctivitis, especially when considering the typical presentations associated with this condition, generally does not include painful and swollen eyelids as a characteristic symptom. Instead, conjunctivitis caused by chlamydia is more often associated with mild discomfort and symptoms such as soreness and slight itching of the eyes.

In detail, while inflammation can occur, the pain and significant swelling of the eyelids is more indicative of other conditions, like allergic conjunctivitis or more severe infections. Chlamydial conjunctivitis tends to present with varying degrees of redness, discharge, and perhaps some itchiness, but it is less likely to produce severe pain or markedly swollen eyelids.

The other characteristics mentioned—sore and slightly itchy eyes, bi/unilateral presentation, and large follicles in the fornix—are indeed typical elements of chlamydial conjunctivitis. The presence of large follicles in the fornix, in particular, is a hallmark of the conjunctival changes seen in this type of conjunctivitis.