Trachoma

  • Trachoma is the most common infectious cause of blindness in the world caused by recurrent ocular surface infection and secondary scarring by the bacterial organism Chlamydia trachomatis.

  • Repeat infection with this organism leads to conjunctival inflammation and scarring, trichiasis, and ultimately blinding corneal opacification and thus a leading cause of preventable blindness.

  • Four ocular serotypes of Chlamydia trachomatis: A, B, Ba and C have been implicated.


RISK FACTORS:

  • Endemic geographical regions: parts of North Africa, Middle East, North west India and parts of Southeast Asia.

  • Limited environmental and social hygiene resources

  • Inadequate water supply with less water available to use for facial cleansing, breeding and transmission of flies that may help spread disease

  • Poor facial hygiene: secretions around the eye attracts flies that are physical vectors for C. trachomatis transmission

  • Overcrowded Living Conditions


MANAGEMENT:

• S: Surgery for Trichiasis

• A: Antibiotics for C. trachomatis infection

• F: Facial cleanliness

• E: Environmental change to improve sanitation and increase access to clean water.


  • Prevention is ideally the best strategy which includes hygiene, public education coupled with increased awareness.

  • Azithromycin and even topical Azithromycin used twice daily for 3 days

  • Supportive treatment: lid and ocular surface hygiene, aggressive lubrication and antibiotics for secondary infections.

SURGICAL: redirect eyelashes and eyelid margin away from the cornea.


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Image from Rajan Eye Care Hospital

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