Trachoma is a long-term infection of the conjunctiva caused by the bacterium Chlamydia trachomatis.
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Trachoma results from infection with certain nonsexually transmitted strains of Chlamydia trachomatis.
Eye redness, watering, irritation, and, if severe, scarring and loss of vision may develop.
The diagnosis is based on the appearance of the eyes and on the duration of symptoms.
Antibiotics are given to treat the infection.
Trachoma is the leading preventable cause of blindness in the world.
Trachoma is common in resource-limited and dry, hot countries in North Africa, the Middle East, the Indian subcontinent, Australia, and Southeast Asia.
In the United States, trachoma is rare, occurring occasionally among American Indians and among immigrants from areas where trachoma is common.
An Inside Look at the Eye
The infection occurs mainly in children, particularly those under the age of 10. Older children and adults are much less likely to have the disorder because of increased immunity and better personal hygiene and sanitation practices.
Trachoma is very contagious in its early stages. The bacteria that cause trachoma are transmitted from person to person through direct contact with infected discharge from the eyes, nose, or throat; by eye–hand contact; and by sharing contaminated objects, such as towels, clothes, and eye makeup. The infection also can be spread by flies that have been in contact with discharge from the eyes or nose of an infected person.
Symptoms of Trachoma
Trachoma usually affects both eyes.
The conjunctivae (the membranes that line the eyelid and cover the white of the eye) become inflamed, red, and irritated, and the eyes water excessively. The eyelids swell. Sensitivity to bright light occurs.
In the later stages, blood vessels may gradually grow across the cornea (called neovascularization), obstructing vision. In some people, the conjunctiva is scarred in such a way that the eyelashes turn inward (trichiasis). As the person blinks, the eyelashes rub against the cornea, causing infection and often permanent damage. Impaired vision occurs in about 13% of people with trichiasis, and blindness occurs in about 8% of people with trichiasis.
Diagnosis of Trachoma
A doctor's evaluation of the symptoms and appearance of the eyes
Doctors suspect trachoma based on the appearance of the eyes and on the duration of symptoms.
Doctors confirm the diagnosis by swabbing the eyes and sending samples to a laboratory where the Chlamydia trachomatis bacteria can be identified. However, often such testing is not necessary or available.
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Treatment of Trachoma
Antibiotics taken by mouth or applied as ointment
Treatment of trachoma consists of an antibiotic (such as azithromycin, doxycycline, or erythromycin) taken by mouth. Alternatively, the antibiotic tetracycline can be applied as an ointment. Treatment of trachoma consists of an antibiotic (such as azithromycin, doxycycline, or erythromycin) taken by mouth. Alternatively, the antibiotic tetracycline can be applied as an ointment.
Doctors often give antibiotics to entire communities where there are many people with trachoma.
If trichiasis damages the eyelid, conjunctiva, or cornea, surgery may be needed.
Prevention of Trachoma
Because trachoma is contagious, reinfection is common. To reduce the spread of the infection, people can do the following:
Access water that is suitable for drinking (potable) and washing.
Regularly wash their face and hands.
Stop sharing towels, washcloths, bedding, and eye makeup.
Control or eliminate places where flies can breed.
