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Trachoma: The Eye Infection You Should Know

September 28, 2023

Trachoma is a bacterial eye infection that is caused by the bacterium Chlamydia trachomatis. It is one of the major global causes of blindness that is preventable and is more common in places with inadequate hygienic conditions and limited access to treatment. Trachoma can spread through contact with an infected person’s eyes, eyelids, nose, or throat secretions. Handling any infected objects, such as handkerchiefs, can potentially spread trachoma.

Trachoma may initially cause mild eye and eyelid itchiness and irritation. Pus may then start to drain from the eyes, and your eyelids may get puffy. This means that the contagious disease primarily affects the conjunctiva, the clear tissue covering the front of the eye, and can lead to vision impairment or even blindness if left untreated.

In this article, we will explore the details of trachoma, from its causes and symptoms to its prevention and available treatments.

Signs and symptoms of trachoma

It usually affects both eyes, and the symptoms may include:

  • Eyes and eyelids itching and irritation
  • Eye discharge
  • Eyelid swelling
  • Eye redness
  • Blurred vision
  • Light sensitivity
  • Eye pain
  • Inverted eyelashes
  • Vision loss

Infection is particularly likely to affect young children, but adults can also be affected.

Stage of trachoma

It has been identified that trachoma develops in five stages:

  • The early stage: Appearance of small bumps or follicles on the inner surface of the upper eyelid that resemble grains of sand, which can only be seen with magnification.
  • Inflammation stage: There is intense inflammation of the eye, causing thickening or swelling of the upper eyelid.
  • Eyelid scarring stage: Due to repeated episodes of inflammation, it leads to scarring of the inner eyelid, which can distort the eyelid and cause it to turn inward distorted and may turn inward (entropion).
  • In-turned eyelashes (trichiasis) stage: The scarred inner lining of your eyelid causes the eyelashes to rub on the outer layer of your eye (cornea), leading to scratching and scarring, and eventually causing the eyelashes to turn inward (trichiasis).
  • Corneal clouding (opacity) stage: Inflammation, which is most frequently observed under your top lid, affects the cornea. The cornea becomes opaque and cloudy as a result of ongoing inflammation that is made worse by scratching from the in-turned lashes.

Causes and risk factors of trachoma

There are several risk factors that contribute to the spread of the infection, including:

  • Age: The infection is more common in children as their immune systems are still developing and they come into contact with infected individuals or contaminated surfaces more easily.
  • Sex: Women and girls are more responsible for household hygiene, which is why they have a higher risk of infection due to their role in caring for family members and younger siblings.
  • Flies: Particularly in areas where the flies are in abundance, they come into contact with contaminated surfaces and then spread the bacteria to other individuals, increasing the likelihood of transmission of trachoma.
  • Poor sanitation: The significant risk factor for trachoma is the lack of access to clean water for personal hygiene and washing, which can increase the possibility of infection.
  • Crowded living conditions: Limited access to clean water and sanitation and crowded living conditions contribute to its prevalence, making it more common in developing regions. It spreads through direct contact with eye discharge or through shared items like towels and washcloths.

Treatment of Trachoma

Early treatment of trachoma may help prevent long-term complications.

However, more severe trachoma cases could necessitate surgery to treat scarring on the eyelids or in-turned eyelashes, which can damage the cornea.

The WHO has created a "S.A.F.E." approach to prevent trachoma, which stands for:

  • Surgery: Surgery may be necessary to correct the condition and prevent further damage to the cornea in individuals with advanced cases of trachoma who have eyelid scarring or in-turned eyelashes (trichiasis).
  • Antibiotics: Antibiotics can be used to treat active trachoma infections and prevent further transmission of the disease. 
  • Facial cleanliness: Improved cleanliness and frequent face washing can help slow the disease’s spread and lower the chance of its transmission.
  • Environmental improvements: Trachoma can be prevented and controlled by enhancing sanitation, ensuring that everyone has access to clean water, and reducing the fly’s populations.

Final thoughts from Ojas – Eye Hospital in Mumbai

Long-term consequences of trachoma must be avoided by early detection and treatment. Regular eye exams and consultations with an eye doctor can help in the early detection of trachoma and ensure that proper care is given.

With proper education, sanitation, antibiotics, and surgical interventions, this eye infection can be prevented. Your eye health is the main priority at Ojas – Eye Hospital in Mumbai. If you have vision problems or just want to make sure your eyes are healthy, come see us in Mumbai.

Ojas Eye Hospital A Center of Excellence for Contoura Vision, Femto Bladefree Lasik in Mumbai, India.