Description

Trachoma (truth-KOH-muh) is a bacterial infection that affects the eyes. It is caused by the bacterium Chlamydia trachomatis. Trachoma is contagious, spreading through contact with the eyes, eyelids, and nose or throat secretions of infected people. It can also be transmitted by handling infected items, such as handkerchiefs.

In the first place, trachoma can cause itching and irritation of the eyes and eyelids. Then you may notice swelling of the eyelids and the presence of pus in the eyes. Without treatment of trachoma can lead to blindness.

Trachoma is the leading preventable cause of blindness throughout the world. The majority of cases of trachoma occur in poor areas of Africa, where 85% of people with active disease reside. In areas where trachoma is common, rates of infection among children under the age of 5 can be 60% or more.

Early treatment can help prevent trachoma complications.

Symptoms

The signs and symptoms of trachoma usually affects both eyes and can include:

  • A mild itching and irritation of the eyes and eyelids
  • Eye discharge containing mucus or pus
  • Swelling of the eyelid
  • Sensitivity to light (photophobia)
  • Pain in the eyes
  • Redness of the eyes
  • The loss of vision

Young children are especially susceptible to the infection. But the disease progresses slowly, and the more painful the symptoms may not emerge until adulthood.

The World Health Organization (WHO) has identified five stages in the development of trachoma:

  • The inflammation-follicular. The early infection has five or more follicles are small bumps that contain lymphocytes, a type of white blood cell — visible with an increase in the internal surface of the upper part of the eyelids (conjunctiva).
  • The intense swelling. In this stage, your eye is now highly infectious and irritated, with a thickening or swelling in the upper eyelid.
  • The eyelids of the scar. Repeated infections lead to scarring of the inside of the eyelids. The scars usually appear as white lines when examined with the expansion. Your eyelid may be distorted and can become in (entropion).
  • Become the eyelashes (trichiasis). The scars lining inside of your eyelid continues to deform, causing your lashes to turn in that is rubbed in and zero in the transparent outer surface of the eye (cornea).
  • Corneal opacity (opacity). The cornea is affected by an inflammation that is most commonly seen in under the top of his cap. Continuous inflammation aggravated by scratching the in-turned eyelashes, leading to the opacity of the cornea.

All the signs of trachoma are more severe in the upper part of the cover on the underside of the lid. Without intervention, a disease process that begins in childhood can continue with the progress in adulthood.

When to see a doctor

Call your doctor if you or your child have itching or irritation of the eyes or of the download of the eyes, especially if you live in or have recently traveled to an area where trachoma is common. Trachoma is a contagious condition. The treatment as soon as possible helps to prevent serious infection.

Causes

Trachoma is caused by certain subtypes of Chlamydia trachomatis, a bacterium that can cause the sexually transmitted infection chlamydia.

Trachoma is spread through contact with secretions from the eyes or nose of an infected person. Hands, clothing, towels, and insects can be a route for transmission. In developing countries, with eyes in search of flies are also a means of transmission.

Risk factors

Factors that increase your risk of contracting trachoma include:

  • To live in overcrowded conditions. The people who live in close contact are at a greater risk of the spread of the infection.
  • The lack of sanitation. Poor sanitary conditions, lack of access to water, and lack of hygiene, such as unclean faces, or hands, to help the spread of the disease.
  • Age. In areas where the disease is active, it is most common in children ages 4 to 6.
  • Sex. In some areas, the women of the rate of contracting the disease is two to six times greater than that of men. This can be attributed to the fact that women have more contact with the children, who are the main reservoir of the infection.
  • The flies. The people who live in areas with problems of control of the fly population may be more susceptible to the infection.

Complications

An episode of trachoma caused by Chlamydia trachomatis is easily treated with early detection and the use of antibiotics. Repeated or secondary infections can lead to complications, including:

  • Scars on the inside of the eyelids
  • Deformities of the eyelids, such as inward folding of the eyelid (entropion) or ingrown eyelashes (trichiasis), which can scratch the cornea
  • Scarring of the cornea or of the clouds
  • Partial or complete vision loss

Prevention

If you've been treated for trachoma with antibiotics or surgery, re-infection is always a concern. For your protection and for the safety of others, be sure that family members or other people living with you, are examined and, if necessary, receive treatment for trachoma.

Trachoma can occur in all the world, but it is more common in Africa, Asia, Latin America, the Middle East, and the Pacific basin. When in the regions where trachoma is common, take special care in the practice of good hygiene, which can help prevent the infection.

Proper hygiene practices include:

  • The face wash and the washing of hands. Keep the faces and hands clean can help to break the cycle of re-infection.
  • The control of the fly. The reduction of fly populations can help to eliminate a source of transmission.
  • Proper waste management. Properly dispose of animal and human waste can reduce the breeding places of flies.
  • Improved access to water. Having a source of fresh water nearby can help to improve hygiene conditions.

Not trachoma vaccine is available, but prevention is possible. The WHO has developed a strategy to prevent trachoma, with the goal of eliminating it by 2020. While the goal has not been achieved, the trachoma cases have decreased significantly. The strategy, entitled SAFE, implies:

  • S urgery for the treatment of advanced forms of trachoma
  • A ntibiotics to treat and prevent infection
  • F acial cleaning
  • E nvironmental improvements, especially in the water, sanitation and the control of the fly

Diagnosis

Your doctor can diagnose trachoma through a physical examination or by sending a sample of the bacteria from your eyes to a laboratory for analysis. But laboratory tests are not always available in areas where trachoma is common.

Treatment

Trachoma treatment options depend on the stage of the disease.

Drugs

In the early stages of trachoma, treatment with antibiotics alone may be sufficient to eliminate the infection. Your doctor may prescribe ophthalmic ointment oral tetracycline or azithromycin (Zithromax). Azithromycin appears to be more effective than tetracycline, but is more expensive.

The World Health Organization (WHO) recommended to administer antibiotics to the entire community when more than 10% of children have been affected by trachoma. The goal of this guide is to treat any person who has been exposed to infection and reduce the spread of trachoma.

Surgery

The treatment of the later stages of trachoma — including painful eyelid deformities may require surgery.

In the lid rotation surgery (bilamellar tarsal rotation), the doctor makes an incision in your scarring of the lid and rotate your lashes away from your cornea. The procedure limits the progression of the scarring of the cornea and can help to prevent a further loss of vision.

If the cornea has become obscured enough to seriously impair your vision, corneal transplant may be an option that may improve vision.

You can have a procedure to remove the tabs (hair removal) in some cases. This procedure may be necessary to make several times.

Preparing for your appointment

It is likely to start by seeing your primary care doctor if you or your child has symptoms of trachoma. Or you may be referred immediately to an eye specialist (ophthalmologist). When you make the appointment, ask if you need to do anything in the meantime, such as keeping your child home from school or child care.

Here's some information to help you prepare for your appointment.

What you can do

Before your appointment, make a list of:

  • The symptoms of the person seeking treatment, including details about the changes in vision
  • Key personal information, such as recent travel, the use of new products in makeup, and a change of glasses or contact lenses
  • All medications and any vitamins or supplements that the person seeking treatment is to take
  • Questions to ask the doctor

To the irritation of the eyes, some basic questions to ask your doctor include:

  • What is the most likely cause of these symptoms?
  • Other that the most likely cause, what are other possible causes of these symptoms?
  • What kind of proof do you need?
  • It is the condition likely temporary or chronic?
  • What is the best course of action?
  • Is this condition because of the long-term complications?
  • Should my child or I follow all the restrictions in place, such as staying home from school or work?
  • You should see a specialist? What will that cost, and will my insurance cover it?
  • Is there a generic alternative to the medicine you're prescribing for me?
  • Do you have any brochures or other printed material for me? What sites do you recommend to visit?

What to expect from your doctor

Your doctor may ask you a series of questions, such as:

  • Have you ever had a similar problem?
  • When did you first begin experiencing symptoms?
  • How severe are the symptoms? That seems to be getting worse?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Is anyone else in your household have similar symptoms?
  • Has been the treatment of their symptoms with medications or fall?

What you can do in the meantime

While you wait for your appointment, good hygiene practices to reduce the possibility of spreading their condition, take the following steps:

  • Don't touch your eyes without washing your hands first.
  • Wash your hands carefully and often.
  • Change your towel and bath towel daily, and don't share them with others.
  • Change your pillowcase often.
  • Dispose of the eye makeup, especially mascara.
  • Do not use anyone eye cosmetics or personal eye care items.
  • Suspend wearing contact lenses until your eyes have been evaluated; then, follow your eye doctor's instructions about the correct way of contact lenses.
  • If your child is infected, it will avoid close contact with other children.
Symptoms and treatment of Trachoma