Trachoma is an infectious bacterial virus which affects the conjunctival layer of the eye, the cornea, and the eyelids. The bacteria associated with the spread of trachoma come through direct contact with the eyes and nose discharge of infected people. Although, approximately 80 million people around the world have active trachoma, it is totally preventable as well as curable. The majority of the affected being children, trachoma is mainly found in under developed and poor tropical countries. WHO estimates that in some of the poorest countries, prevalence among children can reach up to 40%.
With usually very little or no discomfort until the later stages of the disease, trachoma can be hard for an average individual to identify. The primary symptoms in the premature stages of trachoma include:
- Meek itch and irritation in the eyes and eyelids
- Mucus or pus discharge from the eyes
As the disease spread, later trachoma symptoms include:
- Significant sensitivity to light (photophobia)
- Hazy vision
- Eye pain
Children are particularly prone to getting infected, but the disease spreads slowly, and painful symptoms that may encourage an eye examination may not surface until later in life.
The WHO has Introduced a grading system with five phases in the progression of trachoma, including:
Inflammation: This is the initial stage of the infection. Follicles (small bumps containing lymphocytes) are noticeable with magnification on the inner part of the upper eyelid.
Intense inflammation: In this stage, the eye is now very infectious and becomes irritated, with swelling of the upper eyelid.
Eyelid Scarring: As a consequence of recurring infections, the inner eyelid gets scarred. When examined, these scars appear as white lines. This may cause the eyelid to get distorted.
Ingrown Eyelashes: The disfigured inner lining of your eyelid continues to distort, causing your eye lashes to turn in so they scratch the cornea.
Corneal Clouding: Inflammation, commonly seen under the upper eyelid damages the cornea. Constant inflammation combined with scratching from the damaged lashes results in clouding of the cornea. Corneal clouding can also lead to permanent loss of vision.
Prevention and Treatment of Trachoma
Trachoma is normally detected by examining the eyes and the upper eyelids of the patient. In developed countries, the tests are usually carried out by ophthalmologists, while auxiliary personnel in the developing and under developed countries are quite trained to diagnose this disease.
The treatment is fairly straightforward. A single oral dose of antibiotics is the ideal treatment, plus making clean water available and teaching simple hygiene. Because of extensive poverty in most affected areas, this treatment is difficult to put into practice on a large scale.
Treatment involves testing communities for the existence of trachoma in children. When over 10 % are found to have the disease, the whole neighborhood is treated with antibiotics. In areas with lesser people affected, only certain groups are treated.
If trachoma has progressed to disfiguring of the lashes, surgery is necessary to correct this and stop the lashes from blemishing the cornea. Nurses and other medical staff can be taught to perform these surgeries as they can be done without fancy lab equipment.