Trachoma

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A chronic infection of the outer eye caused by Chlamydia trachomatis, transmitted though direct personal contact, shared towels and cloths, and flies that have come into contact with the eyes or nose of an infected person. It is a common cause of blindness.

Clinical features

• Early stages: reddening of eye, itching, follicles (grain-like growth) on conjunctiva
• If repeated untreated infections: scar formation on eyelids causing the upper eyelid to turn inwards (entropion) and the eyelashes to scratch the cornea
• Scarring of the cornea leading to blindness

Differential diagnosis

• Allergic conjunctivitis (chronic)
• Other chronic infections of the eye

ManagementTreatment

Antibiotics

• Tetracycline eye ointment 1% twice daily for 4-6 weeks (until the infection/inflammation has disappeared)
• Or erythromycin 500 mg every 6 hours for 14 days
  • Child: 10-15 mg/kg per dose
• Or azithromycin 1 g stat; child 20 mg/kg stat

If there are any complications

• Refer to specialist
• Surgery for the entropion

Prevention

• Good personal hygiene, regular face washing
• Good hygiene during deliveries
• Education of public on trachoma, and environmental control