Trachoma (truh-KOH-muh) is a bacterial infection that affects your eyes. The bacterium that causes trachoma spreads through direct contact with the eyes, eyelids, and nose or throat secretions of infected people.
Trachoma is very contagious and almost always affects both eyes. Signs and symptoms of trachoma begin with mild itching and irritation of your eyes and eyelids and lead to blurred vision and eye pain. Untreated trachoma can lead to blindness.
Trachoma is the leading preventable cause of blindness worldwide. The World Health Organization (WHO) estimates that 8 million people worldwide have been visually impaired by trachoma. WHO estimates more than 84 million people need treatment for trachoma, primarily in poor areas of developing countries. In some of the poorest countries in Africa, prevalence among children can reach 40 percent.
If trachoma is treated early, it often may prevent further trachoma complications.
The principal signs and symptoms in the early stages of trachoma include:
As the disease progresses, later trachoma symptoms include:
Young children are particularly susceptible to infection, but the disease progresses slowly, and the more painful symptoms may not emerge until adulthood.
The World Health Organization has identified a grading system with five stages in the development of trachoma, including:
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.
When to see a doctor
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 the world's developing countries, flies are a major means of transmission.
Factors that increase your risk of contracting trachoma include:
One episode of trachoma caused by Chlamydia trachomatis is easily treated with early detection and use of antibiotics. However, repeated infection can lead to complications, including:
Preparing for your appointment
You're likely to start by seeing your family doctor or a general practitioner if you have symptoms of trachoma. However, in some cases when you call to set up an appointment, you may be referred immediately to an eye specialist (ophthalmologist).
Because appointments can be brief, and because there's often a lot to talk about, it's a good idea to be well prepared. Here's some information to help you get ready, and what to expect from your doctor.
What you can do
Your time with your doctor is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most important to least important in case time runs out. For eye irritation, some basic questions to ask your doctor include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions during your appointment at any time that you don't understand something.
What to expect from your doctor
What you can do in the meantime
Tests and diagnosis
Most people with trachoma in its initial stages display no signs or symptoms. In areas where the disease is common, your doctor can diagnose trachoma through a physical examination or through sending a sample of bacteria from your eyes to be cultured and tested in a laboratory.
Treatments and drugs
Trachoma treatment options depend on the stage of the disease.
The World Health Organization (WHO) guidelines recommend giving antibiotics to an entire community when more than 10 percent of children have been affected by trachoma, to treat anyone who has been exposed to trachoma and reduce the spread of trachoma.
In eyelid rotation surgery (bilamellar tarsal rotation), your doctor makes an incision in your scarred lid and rotates your eyelashes away from your cornea. The procedure limits the progression of corneal scarring and can help prevent further loss of vision. Generally, this procedure can be performed on an outpatient basis and often significantly reduces the chances of trachoma returning.
If your cornea has become clouded enough to seriously impair your vision, corneal transplantation may be an option that may improve vision. Frequently, however, with trachoma, this procedure doesn't have good results.
You may have a procedure to remove eyelashes (epilation) in some cases. However, this procedure may need to be done repeatedly. Another temporary option, if surgery isn't an available option, is to place an adhesive bandage over your eyelashes to keep them from touching your eye.
If you're traveling to parts of the world where trachoma is common, be sure to practice good hygiene to prevent infection.
If you've been treated for trachoma with antibiotics or surgery, reinfection is always a concern. For your protection and for the safety of others, be sure that family members or others you live with are screened and, if necessary, treated for trachoma.
Proper hygiene practices include:
Although no vaccine is available, trachoma prevention is possible. The World Health Organization (WHO) has developed a health strategy to prevent trachoma, with the goal of eliminating trachoma in the world by 2020. The strategy is titled SAFE, which includes:
Last Updated: 2012-10-03
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