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Trachoma: Treatment, symptoms, advice & help

About trachoma

Trachoma is a chronic and infectious eye disease caused by Chlamydia trachomatis.

Trachoma is the most common cause of avoidable blindness. In endemic areas, the disease is most common in children. Around the world about 80 million people suffer from trachoma infection and about 8 million people are visually impaired as a result of this disease. The classic trachoma environment is described as dry and dirty.

Signs & symptoms of trachoma: Diagnosis

The onset is usually insidious and infection may not be apparent to the patient. Early symptoms include conjunctival irritation and blepharospasm, but the problem may not be detected until vision begins to fail. The early follicles of trachoma are characteristically seen as white lumps in the undersurface of the upper eye lid but clinical differentiation from conjunctivitis due to other viruses may be difficult. Active trachoma will often be irritating and have a watery discharge. Investigations: Intracellular inclusions may be demonstrated in conjunctival scrapings by staining with iodine or immunofluorescence. Chalmydia may be isolated in chick embryo or cell culture.

Causes and prevention of trachoma

Trachoma is caused by Chlamydia trachomatis. Infected children have eye and nose discharges. Transmission occurs through eye, nose or throat secretions spread by flies or fingers or contact with fomites (inanimate objects), such as towels and/or washcloths. Prevention is by personal and family cleanliness. Proper care of the eye of newborns and young children is essential. Family contacts should be examined. The WHO is promoting the SAFE strategy for trachoma control -surgery, antibiotics, facial cleanliness and environmental improvement.

Trachoma: Complications

Secondary bacterial infection may occur and cause a purulent discharge.

The later complications of trachoma include scarring in the eye lid (tarsal conjunctiva) that leads to distortion of the eye lid with buckling of the lid (tarsus) so the lashes rub on the eye (trichiasis). These lashes will lead to corneal opacities and scarring and then to blindness.

Trachoma: Treatment

A single dose of azithromycin (20mg/kg) has been shown to be superior to 6 weeks of 12 hours tetracycline eye ointment for individuals and in mass treatment programmes. Deformity and scarring of the lids, and corneal opacities, ulceration and scarring may require surgical treatment after control of local infection.