Trachoma

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Definition

What is trachoma?

Trachoma is a bacterial infection that affects your eyes. It’s contagious, spreading through contact with the eyes, eyelids, and nose or throat secretions of infected people. It can also be passed on by handling infected items, such as handkerchiefs.

At first, trachoma may cause mild itching and irritation of your eyes and eyelids. Then you may notice swollen eyelids and pus draining from the eyes. Untreated trachoma can lead to blindness.

The World Health Organization has identified five stages in the development of trachoma:

  • Inflammation — follicular. The infection is just beginning in this stage. Five or more follicles — small bumps that contain lymphocytes, a type of white blood cell — are visible with magnification on the inner surface of your upper eyelid (conjunctiva).
  • Inflammation — intense. In this stage, your eye is now highly infectious and becomes irritated, with a thickening or swelling of the upper eyelid.
  • Eyelid scarring. Repeated infections lead to scarring of the inner eyelid. The scars often appear as white lines when examined with magnification. Your eyelid may become distorted and may turn in (entropion).
  • Ingrown eyelashes (trichiasis). The scarred inner lining of your eyelid continues to deform, causing your lashes to turn in so that they rub on and scratch the transparent outer surface of your eye (cornea).
  • Corneal clouding. The cornea becomes affected by an inflammation that is most commonly seen under your upper lid. Continual inflammation compounded by scratching from the in-turned lashes leads to clouding of the cornea.

How common is trachoma?

Trachoma is the leading preventable cause of blindness worldwide. The World Health Organization (WHO) estimates that 6 million people have been blinded by trachoma. Most blinding trachoma occurs in poor areas of Africa. Among children under 5, prevalence of active trachoma infections can be 60 percent or more. Please discuss with your doctor for further information.

Symptoms

What are the symptoms of trachoma?

The common symptoms of trachoma are:

  • Mild itching and irritation of the eyes and eyelids
  • Discharge from the eyes containing mucus or pus
  • Eyelid swelling
  • Light sensitivity (photophobia)
  • Eye pain

Young children are particularly susceptible to infection. But the disease progresses slowly, and the more painful symptoms may not emerge until adulthood.

All the signs of trachoma are more severe in your upper lid than in your lower lid. With advanced scarring, your upper lid may show a thick line.

In addition, the lubricating glandular tissue in your lids — including the tear-producing glands (lacrimal glands) — can be affected. This can lead to extreme dryness, aggravating the problem even more.

There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.

When should I see my doctor?

Call your doctor if you or your child has itchy or irritated eyes or discharge from the eyes, especially if you live in or recently traveled to an area where trachoma is common. Trachoma is a contagious condition. Treating it as soon as possible helps prevent further infections.

Causes

What causes trachoma?

Trachoma is caused by certain subtypes of Chlamydia trachomatis, a bacterium that can also cause the sexually transmitted infection chlamydia.

Trachoma spreads through contact with discharge from the eyes or nose of an infected person. Hands, clothing, towels and insects can all be routes for transmission. In developing countries, eye-seeking flies also are a means of transmission.

Risk factors

What increases my risk for trachoma?

There are many risk factors for trachoma, such as:

  • Trachoma is primarily a disease of extremely poor populations in developing countries.
  • Crowded living conditions. People living in close contact are at greater risk of spreading infection.
  • Poor sanitation. Poor sanitary conditions and lack of hygiene, such as unclean faces or hands, help spread the disease.
  • In areas where the disease is active, it’s most common in children ages 4 to 6.
  • In some areas, women’s rate of contracting the disease is two to six times higher than that of men.
  • People living in areas with problems controlling the fly population may be more susceptible to infection.
  • Lack of latrines. Populations without access to working latrines — a type of communal toilet — have a higher incidence of the disease.

Diagnosis & treatment

The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.

How is trachoma diagnosed?

Tests used to diagnose trachoma may include:

  • Medical history
  • Physical examination including an eye examination (including everting or flipping the eyelid)
  • Eye swab for laboratory testing, but the diagnosis is normally made by clinical examination.

How is trachoma treated?

Treatment depends on the severity of the condition, but may include:

  • Antibiotic medications – a single oral dose of an antibiotic (azithromycin) is the first line of treatment in uncomplicated cases. This medication kills off the bacteria so that the body’s natural healing processes can repair the eye. Antibiotics must be given to all household members where trachoma is found. In areas where there is widespread infection, the whole community may need to be treated. Treatment may need to be repeated every six to 12 months
  • Surgery – this is used to correct the eyelid deformity and evert (turn outwards) the injured eyelashes in older people.

Lifestyle changes & home remedies

What are some lifestyle changes or home remedies that can help me manage trachoma?

The following lifestyles and home remedies might help you avoid trachoma:

  • Face washing and hand-washing. Keeping faces clean may help break the cycle of reinfection.
  • Controlling flies. Reducing fly populations can help eliminate a major source of transmission.
  • Proper waste management. Properly disposing of animal and human waste can reduce breeding grounds for flies.
  • Improved access to water. Having a fresh water source nearby can help improve hygienic conditions.

If you have any questions, please consult with your doctor to better understand the best solution for you.

Hello Health Group does not provide medical advice, diagnosis or treatment.

Review Date: December 14, 2017 | Last Modified: December 15, 2017

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