Trachoma

Trachoma is a chronic infectious disease caused by Chlamydia trachomatis, leading to conjunctival inflammation and scarring that can result in blindness if untreated. It is a major cause of preventable blindness worldwide, particularly in poor, rural areas with limited access to clean water and healthcare.

Any person with red stickly eyes who complaints of pain and itchiness of the eyes.

Is a chronic infection of the cunjunctiva and cornea caused by bacteria called chlamydia trachomatis.

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Signs and Symptoms

Trachoma progresses through five stages:

1. Follicular Trachoma – Small follicles (bumps) appear on the inner eyelid.
2. Intense Inflammation – Severe redness and swelling of the conjunctiva.
3. Eyelid Scarring – Repeated infections cause scarring of the inner eyelid.
4. Trichiasis – The eyelashes turn inward and rub against the cornea.
5. Corneal Opacity – Scarring of the cornea leads to vision loss and blindness.

Additional symptoms include:

• Eye redness and irritation
• Discharge from the eyes
• Sensitivity to light (photophobia)
• Blurred vision in later stages

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Complications

• Corneal ulceration
• Chronic eye pain
• Vision impairment or blindness
• Secondary bacterial infections

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Transmission

Trachoma spreads through:

• Direct contact with eye or nasal secretions from an infected person
• Contaminated hands, towels, and clothes
• Flies (particularly Musca sorbens) acting as mechanical vectors

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Causative Agent

Trachoma is caused by Chlamydia trachomatis (serotypes A, B, Ba, and C).

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Incubation Period

The incubation period ranges from 5 to 12 days after exposure.

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Reservoir

Humans are the primary reservoir for Chlamydia trachomatis.

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Prevention and Control Measures

The SAFE strategy is recommended by the WHO:

• S: Surgery – To correct trichiasis and prevent blindness.
• A: Antibiotics – Mass drug administration with azithromycin to eliminate infection.
• F: Facial cleanliness – Promoting hygiene to reduce transmission.
• E: Environmental improvement – Better sanitation and access to clean water to reduce fly breeding.

Additional measures include:

• Avoiding sharing personal items like towels and handkerchiefs.
• Educating communities about hygiene practices.

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Laboratory Diagnosis

• Giemsa Staining – Detects intracellular Chlamydia trachomatis in conjunctival swabs.
• Nucleic Acid Amplification Tests (NAATs) – Most sensitive and specific test for detecting C. trachomatis DNA.
• Direct Fluorescent Antibody (DFA) Test – Detects chlamydial elementary bodies.
• Enzyme-Linked Immunosorbent Assay (ELISA) – Identifies chlamydial antigens.

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Treatment

• Antibiotics:
  • Azithromycin (single oral dose of 1g) – Preferred treatment.
  • Tetracycline (1% eye ointment, twice daily for 6 weeks) – Alternative treatment.
• Surgical intervention for trichiasis and corneal complications.
• Symptomatic treatment with artificial tears or anti-inflammatory drops.

Early treatment and mass drug administration in endemic areas help control and eliminate trachoma.