Trachoma is a bacterial infection of the eyes. Chlamydia trachomatis is the organism that causes it. Trachoma is infectious, spreading by contact with infected people's eyes, eyelids, nose, or throat secretions. Handling contaminated things, such as handkerchiefs, can potentially spread it.
Trachoma may initially cause moderate discomfort and irritation of your eyes and eyelids. You may then see puffy eyelids and fluid pouring from your eyes. Trachoma can cause blindness if left untreated.
Trachoma is the most common avoidable cause of blindness in the world. The majority of trachoma incidences occur in impoverished parts of Africa, where 85 percent of persons with active illness live. In locations where trachoma is endemic, infection rates among children under the age of five can reach 60% or higher.
Trachoma problems may be avoided if treated early.
WHAT ARE THE SYMPTOMS OF TRACHOMA?
Trachoma symptoms and signs often involve both eyes and may include:
- Mild inflammation and itching of the eyes and eyelids
- Mucus or pus-containing eye discharge
- Redness of the eyes
- Loss of vision
- Puffiness of the eyelids
- Sensitivity to light (photophobia)
- Eye pain
Young children are more vulnerable to illness. However, the condition advances slowly, and the more severe symptoms may not appear until maturity.
The World Health Organization (WHO) has recognized five phases of trachoma development:
- Inflammation — follicular: The early infection contains five or more follicles — little lumps on the inner surface of your upper eyelid that house lymphocytes, a kind of white blood cell — visible with magnification (conjunctiva).
- Inflammation — intense: At this point, your eye has become infected and inflamed, with a thickening or swelling of the upper eyelid.
- Scarring on the eyelids: Scarring of the inner eyelid occurs as a result of repeated infections. When seen under magnification, the scars frequently look as white lines. Your upper eyelid may get deformed and turn in (entropion).
- In-turned eyelashes (trichiasis): Your eyelid's scarred inner lining continues to distort, causing your lashes to turn in and rub against and irritate the translucent outer surface of your eye (cornea).
- Corneal clouding (opacity): An inflammation, most usually noticed behind your top lid, affects the cornea. Continuous inflammation, exacerbated by scratching from the in-turned lashes, causes corneal clouding.
All trachoma symptoms are more severe in your upper lid than in your lower lid. A disease process that begins in childhood can progress into adulthood if not treated.
WHAT ARE THE CAUSES OF TRACHOMA?
Certain variants of Chlamydia trachomatis, a bacterium that may also cause the sexually transmitted diseases chlamydia, produce trachoma.
Trachoma spreads by contact with fluid from an infected person's eyes or nose. Transmission can occur through the use of hands, clothes, towels, and insects. Eye-seeking flies are also a mode of transmission in poor nations.
WHAT ARE THE RISK FACTORS FOR TRACHOMA?
The following factors enhance your chances of acquiring trachoma:
- Crowded living conditions: People who live in close quarters are more likely to spread illness.
- Inadequate sanitation: Poor sanitary conditions, insufficient access to water, and a lack of cleanliness, such as filthy faces or hands, all contribute to the spread of the disease.
- Age: In locations where the illness is active, children aged 4 to 6 are the most affected.
- Sex: In certain locations, women are two to six times more likely than males to get the condition. This might be because women have more interaction with children, who are the major reservoir of illness.
- Flies: People who live in places where the fly population is difficult to manage may be more vulnerable to illness.
WHAT ARE THE COMPLICATIONS OF TRACHOMA?
Trachoma caused by Chlamydia trachomatis is readily cured if detected early and antibiotics are given. Repeated or secondary infections might result in consequences such as:
- Scarring on the inside of the eyelid
- Deformities of the eyelids, such as an inward-folding eyelid (entropion) or ingrown eyelashes (trichiasis), can scrape the cornea.
- Scarring or cloudiness of the cornea
- Vision loss, either partially or fully
HOW IS TRACHOMA DIAGNOSED?
Trachoma can be diagnosed physically or by sending a sample of germs from your eyes to a laboratory for testing. However, lab testing are not always available in areas where trachoma is prevalent.
WHAT ARE THE TREATMENTS FOR TRACHOMA?
Trachoma treatment methods vary according on the stage of the illness.
Medications
In the early stages of trachoma, medications alone may be sufficient to eradicate the infection. Tetracycline eye ointment or oral azithromycin may be prescribed by your doctor (Zithromax). Although azithromycin looks to be more successful than tetracycline, it is more costly.
When more than 10% of youngsters in a community develop trachoma, the World Health Organization (WHO) recommends administering antibiotics to the whole population. The purpose of this recommendation is to treat everybody who has been exposed to trachoma and to prevent its spread.
Surgery
Later stages of trachoma, involving painful eyelid abnormalities, may necessitate surgery.
Your doctor will make an incision in your scarred lid and twist your eyelashes away from your cornea during eyelid rotation surgery (bilamellar tarsal rotation). The technique slows the advancement of corneal scarring and may help avoid additional vision loss.
If your cornea has grown cloudy to the point that it is substantially impairing your vision, corneal transplantation may be a possibility.
In some situations, you may undergo an eyelash removal surgery (epilation). This procedure may have to be repeated.
HOW CAN TRACHOMA BE PREVENTED?
If you've had trachoma treated with antibiotics or surgery, reinfection is always a possibility. Make sure that family members or people you live with are checked and, if required, treated for trachoma for your own safety and the safety of others.
Trachoma is found all over the world, although it is most frequent in Africa, Asia, Latin America, the Middle East, and the Pacific Rim. When visiting areas where trachoma is prevalent, take extra precautions to practice proper hygiene, which can help avoid infection.
Proper hygiene procedures include the following:
- Hand-washing and face washing: Keeping faces and hands clean may aid in breaking the reinfection cycle.
- Fly control: Reduced fly populations can aid in the elimination of a source of transmission.
- Proper waste management: Properly disposing of animal and human waste can help to limit flies' breeding grounds.
- Improved water access: A nearby source of fresh water can assist enhance sanitary conditions.
There is no trachoma vaccination, although prophylaxis is feasible. The WHO has established a trachoma prevention plan with the objective of eradicating it by 2020. While the aim has not been completely met, trachoma occurrences have decreased dramatically. The SAFE approach entails the following steps:
- S: Surgery to treat severe cases of trachoma
- A: Antibiotics to cure and prevent infection
- F: Facial cleanliness
- E: Environmental improvements, notably in the areas of water, sanitation, and fly control