Trachoma: Symptoms, Causes, Treatment

What are the symptoms of trachoma?

Trachoma is an eye infection caused by the bacterium Chlamydia trachomatis. Its symptoms can vary depending on the stage of the disease:

• Early Symptoms: It starts with mild symptoms including eye redness, irritation, and discomfort. There may be a feeling of grit or foreign body in the eye.
• Progressive Symptoms: As the infection progresses, it can cause itching and a discharge from the eyes. The eyelids may swell, and the eyes can become more sensitive to light (photophobia). Conjunctivitis (inflammation of the conjunctiva) is common.
• Advanced Symptoms: In advanced stages, repeated infections can lead to scarring of the inner surface of the eyelids (trachomatous scarring). This scarring can cause the eyelashes to turn inward (trichiasis), leading to painful abrasion of the cornea. This condition can impair vision and potentially lead to blindness if left untreated.
• Chronic Effects: Long-term effects include permanent damage to the cornea and possible vision loss. The condition can also cause secondary complications such as corneal ulcers and infections.

Early diagnosis and treatment are crucial to prevent progression and complications associated with trachoma.

What are the causes of trachoma?

Trachoma is caused by an infection with the bacterium Chlamydia trachomatis. The primary causes and factors that contribute to trachoma include:

• Bacterial Infection: The infection is spread through direct contact with eye discharge from an infected person or through contact with contaminated clothing, towels, or bedding.
• Poor Sanitation: Trachoma is more prevalent in areas with inadequate sanitation and poor hygiene. Dirty hands, unclean living conditions, and lack of access to clean water contribute to the spread of the infection.
• Crowded Living Conditions: Living in close quarters, such as in crowded households or refugee camps, increases the likelihood of transmission.
• Flies: Houseflies and other insects that come into contact with the eyes and face of infected individuals can carry the bacteria and contribute to its spread.
• Lack of Access to Medical Care: Limited access to healthcare and antibiotics for treatment of the infection can lead to untreated or recurrent cases, which can cause long-term damage.
• Recurrent Infections: Repeated infections, especially during childhood, increase the risk of developing severe complications like scarring and blindness.

What is the treatment for trachoma?

Treatment for trachoma typically involves a combination of antibiotics and surgical interventions, depending on the severity of the disease. Here’s how it is generally managed:

• Antibiotics: The primary treatment for trachoma is the use of antibiotics to eliminate the Chlamydia trachomatis infection. The World Health Organization (WHO) recommends the use of azithromycin, a single oral dose, for the mass treatment of trachoma in affected communities. Tetracycline or doxycycline may also be used, especially in cases where azithromycin is not available or suitable.
• Surgical Intervention: In advanced stages of trachoma, where there is scarring of the eyelids (trichiasis), surgery may be necessary to correct the position of the eyelashes and prevent them from scratching the cornea. This procedure is known as eyelid surgery or trichiasis surgery.
• Facial Hygiene: Improving facial cleanliness can help prevent the spread of the infection. Education on proper hygiene practices and the importance of washing hands and face regularly is crucial.
• Environmental Improvements: Ensuring access to clean water, improving sanitation, and reducing overcrowding can help reduce the incidence of trachoma. Efforts to control and prevent the spread of flies also play a role in managing the disease.
• Community-Wide Programs: Trachoma control programs often involve community-wide treatment campaigns to ensure that all individuals in affected areas receive antibiotics, even if they do not show symptoms, to reduce the overall burden of the disease.

Effective management combines these approaches to address both the immediate infection and the long-term prevention of recurrence and complications.