Trachoma Epidemiology Symptoms Diagnosis and Treatment

What is Trachoma?

Trachoma (трахома, التراخوما) is an ocular infectious disease caused by infection with the bacterium Chlamydia trachomatis, leading to inflamed granulation on the inner surface of the eyelids and roughening of the inner surface of the eyelids.

Trachoma is the world’s most common cause of postinfectious ocular morbidity and blindness.[1]

The incubation period of trachoma is about five to twelve days, after which the infected patient experiences symptoms of conjunctivitis (pink eye) such as blurred vision, itchy eyes, epiphora (excessive tearing or increased amount of tears), eyelid redness (blepharitis), burning eyes, photophobia (light sensitivity or increased sensitivity to light), green or white eye discharge, thick yellow eye discharge that crusts over the eyelashes.

It is present in 42 countries, and is responsible for the visual impairment and blindness of about 2 million people. Worldwide, more than 80 million people have active trachoma.[1]

What are the signs and symptoms of trachoma?

Signs and symptoms of trachoma may include:

1- Itchy eyelids and slight redness of the eyes
2- Eye Discharge containing mucus or pus
3- Swollen eyelids
4- Photophobia or Light sensitivity
5- Watery, red and itchy eyes
6- Eye pain

What is the cause of trachoma?

Trachoma is caused by bacterium chlamydia trachomatis. Moreover, C. trachomatis is one of four bacterial species in the genus Chlamydia that can also cause chlamydia infection (a sexually transmitted infection). The disease spreads through contact with ocular or nasal discharge of an infected individual.

How to diagnose trachoma?

Trachoma is suspected according to the clinical symptoms and signs.  In most cases, the diagnosis is usually made by examining the eyes and eyelids. In developed countries, the diagnosis is made using slit lamp biomicroscopy. The slit lamp biomicroscope is an instrument used to detect characteristic changes in the conjunctiva, cornea, and tear film, it is used to inspect the transparent, axial tissue of the eyes and to indicate the sharpness or clarity of vision.

How to treat trachoma?

The treatment of Trachoma is relatively simple. the treatment plan involves a single oral dose of azithromycin with instructions to make environmental improvement and lifestyle changes and to maintain self-hygiene (facial cleanliness); However, this regimen is difficult to implement because of widespread poverty in endemic areas.

In the early stages of the disease, the topical use of 1% tetracycline eye ointment (Achromycin) or the onetime use of oral azithromycin (Zithromax pills) are commonly prescribed to eliminate the infection. However, Azithromycin proven more effective than tetracycline.

Treatment involves treating all who might be in contact with the infected patients and screening the entire community for the presence of trachoma, especially children aged 1-9 years. Positive screening results when over 10 % are found to have trachoma, the entire community is treated with antibiotics. In case of positive screening results when less than 10% are found to have trachoma, only suspected groups are treated.

In the later stages of trachoma, when the eyelids turn inwards and when the eyelashes turn inward to touch the eyeball, surgery is indicated to correct the situation and prevent the eyelashes from scarring the cornea. In case of corneal scarring, corneal transplantation surgery is indicated.

Can trachoma be prevented?

Blindness from trachoma is totally preventable. This can be achieved by a single oral dose of azithromycin with instructions to make environmental improvement and lifestyle changes and to maintain self-hygiene (facial cleanliness). It’s important to mention that many countries eradicated trachoma using these steps.

References

Verified by: Dr.Diab (December 19, 2023)

Citation: Dr.Diab. (December 19, 2023). Trachoma Epidemiology Symptoms Diagnosis and Treatment. Medcoi Journal of Medicine, 12(2). urn:medcoi:article18046.