Trachoma

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This is an infection of the eye caused by Chlamydia Trachomatis. It is a disease of the underprivileged communities, with poor hygienic conditions. The common fly is the major vector in the infection and re-infection cycle. It is one of the leading causes of preventable blindness in the world.

Characterized by an acute inflammation which appears in the first decade of life, slowly progressing until the disease becomes inactive during the 2nd decade of life. Last sequelae may not appear for many years.

Stages

  • Trachoma Follicular (TF): characterized by follicles on the upper lid conjunctiva
  • Trachoma intense (TI):, characterized by acute red tarsal conjunctiva with obliteration of blood vessel
  • Trachoma Scaring (TS): Tarsal conjunctiva starts showing lines of scaring
  • Trachoma Trichiasis (TT): – upper eyelid turns in, because of extreme scarring and shortening of lid conjunctiva causing corneal damage and ulceration
  • Ulcerated Cornea (CO): starts scaring forming corneal opacification

Clinical features
Symptoms

  • None
  • Red eyes
  • Ocular discomfort

Signs

  • Follicles on the tarsal conjunctiva
  • Eyelid conjunctional scaring
  • In-turning of eyelids (entropion)
  • Eyelashes rubbing on the cornea (Trichiasis) heading to corneal ulceration
  • Corneal scars

Treatment
WHO recommends adopting the SAFE strategy in proven endemic areas (after conducting the survey).

S Surgery for stage 5
A Mass Antibiotic treatment. A single dose of Azithromycin 500mg. In children 10mg/kg/bd/wt as start dose .
F Face washing (provision of clean and safe water – a multi-disciplinary approach where MOH partners with other line Ministries responsible for safe water as well as some international NGOs that fund this expensive aspect of Trachoma control.
E Environmental sanitation – It’s a public health aspect of management