What is Trachoma?
This is an infection caused by bacteria that distresses the eyes. The bacterium causing trachoma migrates thru direct contact with the eyelids, eyes, and nose or thru secretions of individuals who are infected. Trachoma is extremely contagious as well as almost always involving both eyes. Systems and signs of trachoma begin with itching that is mild as well as irritation of the eyes and eyelids and lead to vision which is blurred and pain in the eye. Trachoma which is untreated can cause blindness.
This infection is the leaving preventable cause of worldwide blindness. The World Health Organization or WHO has estimated that 8 million individuals worldwide have been impaired visually by trachoma. In Western countries, few individuals have heard of this disease but in the countries which are poorest in Africa, the prevalence especially among children can reach up to 40%.
When treated early, the prognosis for individuals with trachoma is excellent.
Trachoma Symptoms
The major symptoms or signs of the initial stages of trachoma consist of:
- Irritation and mild itching of the eyelids or eyes
- Drainage from the eyes contains pus or mucus
As this disease progresses, trachoma symptoms begin to include:
- Blurred vision
- Marked sensitivity to light referred to as photophobia
- Pain in the eye
Young children are most susceptible to this disease but the infection normally advances gradually and the most painful signs or symptoms normally will not develop until adult hood.
WHO has developed a classifying system with 5 phases in the expansion of trachoma. These stages are:
Inflammation-follicular
This infection is only beginning. 5 or extra follicles, small
Lumps containing lymphocytes
lumps containing lymphocytes, a type of white blood cell, are on the inner surface of the upper eyelid or conjunctiva and are usually visible with magnification.
Inflammation-intense
In this stage, the eye is now very highly infectious as well as becoming irritated with thickening or swelling of the upper eyelid.
Eyelid scarring
After repeated infections there will be scarring of the inner eyelid. These scars usually appear as white lines when examined with magnification. Eyelids can turn in (known as entropion) and become distorted.
Trichiasis, or eyelashes that are ingrown
The inner lining of the eyelid that is scarred continues to deform which causes the lashes to turn in so they then rub on and scratch the outer surface of the cornea which is transparent. Only approximately 1 percent of individuals with trachoma develop this painful condition.
Clouding of the corneal
The cornea becomes affected by an inflammation that is more commonly seen under the upper eyelid. Inflammation that is continual and compounded by scratching of the turned in lashes can lead to corneal clouding. Secondary infection may lead to the development of corneal ulcers and ultimately partial or complete blindness.
All the symptoms of trachoma are most severe when in the upper lid than the lower lid. With scarring that is advanced, the upper lid can show a curve that is S-shaped. Additionally, the glandular tissue that lubricates the lids – including the glands that produce tears (lacrimal glands) – may be affected. This may lead to dryness is extreme, which aggravates the problem even more.
An individual should call their physician if they are their child have itching, discharge from the eyes, or irritation, specifically if the individuals have traveled to some area where trachoma is common.
Trachoma Causes
This disease is caused by definite subtypes of Chlamydia trachomatis, which is a bacterium that may also cause the STD or sexually transmitted disease chlamydia.
Trachoma is spread thru contact with any discharge from the nose or eyes of an individual who is infected. Hands, towels, clothing as well as insects can all be transmission routes. In the developing countries of the world, flies are also a major transmission means.
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Factors that can increase the risk of contracting trachoma include:
Poverty
This disease is mainly a disease of population that are extremely poor.
Living conditions are crowded
Individuals living in close contact are at a greater risk of infection spreading
Age
In those areas where this disease is endemic, it is most common in children ages three to six.
Poor sanitation
Hygienic conditions which are poor contribute to the spread of the disease.
Sex
Women have this disease at a much higher rate than men. Women also are blinded up to 3 times more than men are.
Access to water is poor
Homes that are at a greater distances from supplies of water are also more susceptible to infection
Flies
Individuals living in areas where there are problems controlling the population of flies can be more susceptible.
Lack of latrines
Area where populations are without or have limited access to working latrines or communal toilets have a much greater incidence of this disease.
One episode of an infection with Chlamydia trachomatis is easy to treat with early detection together with the use of antibiotics. But, infections that are repeated will lead to complications, including:
- Inner eyelid scarring
- Deformities of eyelids
- Folding of the eyelid inward – entropion
- Eyelashes that are ingrown
- Corneal cloudiness or scarring
- Partial or complete vision loss
Trachoma Diagnosis
Most individuals with trachoma in its initial stages has no symptoms or signs. In those areas where the trachoma is endemic, a physician usually can diagnose trachoma thru a physical exam or thru a sample of bacteria from the eyes being sent to the lab for culturing and testing.
Trachoma Treatment
The treatment options for trachoma normally depend on the disease stage.
Medications
In the early stages of trachoma, treatment with antibiotics alone can normally be sufficient to cure the infection. The 2 medications normally in use include an oral azithromycin with brand name of Zithromax, and a tetracycline eye ointment. While azithromycin seems to be more nominal than tetracycline, azithromycin is usually more expensive. In communities which are poor, the medication usually depends on the one that is not only available but also affordable.
Surgery
For later stages of trachoma, including painful deformities of the eyelid, treatment may include surgery. In eyelid rotation surgery, also known as bilamellar tarsal rotation, the physician will make an incision in the scarred lid and rotate the eyelashes away from the cornea. This procedure restricts the growth of scarring of the cornea and may improve eyesight. Normally, this procedure can be executed on an outpatient basis and takes less than 15 minutes had usually has a good success rate long-term.
When the cornea becomes clouded enough to impair vision seriously, a corneal transplantation is an option that can offer hope of vision that is improved. Frequently, though, the end results are not very good.
Trachoma Pictures
