Trachoma is a microbial infection of the eye, caused due to the bacterium Chlamydia trachomatis. It is a contagious disease, that can be easily spread by direct contact with an affected person, by means of their eyes, eyelids, nasal and throat secretions and exchange of used towels and handkerchiefs.

Trachoma gives rise to roughness in the inner regions of the eyelids, eventually leading to severe pain and breakdown of the cornea (the outer surface of the eye). It prominently scars only the upper eyelid, with the lower eyelid showing only mild indications.

The risk factors of trachoma are poor sanitation, crowded living conditions and lack of routine hygiene practices due to poverty. Moreover, trachoma commonly occurs in children between the ages of four and six years, more frequently in adult women than men and in surroundings where flies are rampant, as these can serve as vectors to transmit the bacteria.

If left untreated, trachoma damages the tear-producing lubricating glands known as lachrymal glands in the eye, and ultimately resulting in complete blindness. Hence, it is advised to promptly seek medical care, when you notice signs of irritation or discharge in your eyes.

Trachoma stages

Symptoms:

The characteristic symptoms of trachoma affect both the eyes and comprise of the following:

  • Scratching and soreness of eyes and eyelids
  • Liquid release from the eyes consisting of mucus or pus
  • Increased sensitivity to light, known as photophobia
  • Pain and discomfort in the eye

In addition, the WHO (World Health Organization), with a goal to completely eradicate this disease globally by the year 2020, has enlisted the stages of progression of trachoma, to spread awareness of its associated traits and appearance:

1.    Follicular Inflammation:

This marks the onset of the eye infection, where only around five follicles (small bumps containing lymphocytes – a type of white blood cell) appear on the inner surface of the upper eyelid as in the case of stye.

2.    Intense Inflammation:

The second stage of trachoma, this causes intense irritation and swelling of the upper eyelid due to the proliferation of many follicles.

3.    Eyelid Scarring:

Scars show up in infected eyelids in the form of white lines and ultimately invert the eyelid – a state known as entropion.

4.    Ingrown Eyelashes (Trichiasis):

Further distortion of the eyelid occurs in this phase and the eyelashes come in contact with the cornea, resulting in scratching and rashes.

5.    Corneal Clouding:

A sheet of translucent deposit encompasses the cornea, as the infection has completely spread under the eyelids, causing clouding of vision as seen in keratoconus.

Diagnosis And Treatment:

To diagnose trachoma, there are no specific laboratory tests. The eye doctor or ophthalmologist conducts a thorough physical examination of the eye and also detects if any eye infection or bacterial contamination is present.

Once the instance of trachoma is confirmed, treatment options are determined based on the stage of the disease.

The healthcare provider ideally prescribes antibiotics, either to be taken orally or applied topically on the eye, to significantly reduce the swelling in eyelids and combat the bacteria present in the eyes, if trachoma is still in the initial two stages in the patient.

In cases of the advanced stages of the disease, invasive procedures such as eyelid rotation, corneal transplantation and epilation or removal of eyelashes are performed by the surgeon, to effectively treat trachoma and restore healthy eyesight.

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