Trachoma (truh-KO-muh) is a bacterial infection that affects the eyes. The bacterium that causes trachoma spreads through direct contact with the eyes, eyelids, 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 the 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. In Western countries, few people know about the disease, but in the poorest countries in Africa, prevalence among children can reach 40 percent.
If treated early, the prognosis for people with trachoma is excellent.
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. The stages are:
All the signs of trachoma are more severe in the upper lid than in the lower lid. With advanced scarring, the upper lid may show an S-shaped curve. In addition, the lubricating glandular tissue in the 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 disease 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 infection with 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 of ground to cover, 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 endemic, a 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.
If the cornea has become clouded enough to seriously impair vision, corneal transplantation is an option that offers some hope of improved vision. Frequently, however, the results are not good.
If you're traveling to parts of the world where trachoma is endemic, 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. For instance, trachoma virtually disappeared in the United States by the 1950s due to improved sanitation and living conditions. The disease has also almost disappeared in certain countries, such as Morocco, where health organizations have been active in public education and have helped promote therapies known to cure the disease.
Last Updated: 2010-07-17
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