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 Trachoma

How is trachoma detected?
What is the treatment for trachoma?

Trachoma is a chronic infection of the conjunctiva, the thin membrane that covers the outer surface of the eye and the inside lining of the eyelids. It is caused by a microorganism that grows only within eyelid cells, and it is one of the oldest infectious diseases, dating back several thousand years. Because the disease is not fatal and causes progressive rather than sudden damage to the eyes, it is often not taken seriously and may even be accepted as a fact of life in some countries. The trachoma infection is the leading cause of blindness in the world.

The disease is rare in the United States and is most often seen in third-world and developing nations where poverty, overcrowding, personal hygiene, and access to clean water and health care are problems. It is prevalent in many African countries, parts of Central and South America, and some countries in the Eastern Mediterranean and in Asia.

Trachoma is caused by infection with the microorganism Chlamydia trachomatis and is highly infectious, usually spread by contact with eye or nose discharge from an infected person. It is also transmitted by flies and gnats that are attracted to eyes and runny noses. Because it is easily transmitted from person to person, the disease often strikes entire communities.

How is trachoma detected?

In the early stages, trachoma resembles conjunctivitis. It starts with an inflamed outer lining of the eye (conjunctiva) and is accompanied with eye discharge and sticky, red eyes. Tearing, light sensitivity, swollen eyelids, pain, and corneal inflammation are some of the first symptoms. As the disease progresses over time, the recurring infections cause scarring on the inside of the eyelid. Eventually the inside of the eyelids are scarred so badly that they turn inward with the eyelashes rubbing the eyeballs, scratching the lenses of the eyes with each blink and causing corneal ulcerations that become infected. This scarring leads to blindness. Although trachoma begins in childhood, blindness usually does not occur until the age of 40 or 50 after repeated infections cause inflammation and scarring.

What is the treatment for trachoma?

In the early stages of the infection, antibiotics can effectively treat trachoma. However, if the disease progresses, as is often the case in underdeveloped countries, treatment becomes difficult. After scarring begins, a simple surgical procedure known as tarsal rotation is required to reverse the inturned eyelashes. Surgeries to repair lid deformities and corneal transplants are also options, but are not available to most people who are afflicted by the disease. Trachoma is preventable with proper diet, sanitation and education. By simply washing their faces and hands, children will not spread the infection.

Although blindness from trachoma has been eliminated in several countries around the world, the disease continues to be a serious public health problem in many underdeveloped areas.

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