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Trachoma
Definition
Trachoma is a bacterial infection of the eye.
Alternative Names
Granular conjunctivitis; Egyptian ophthalmia; Conjunctivitis - granular
Causes
Trachoma is caused by infection with the bacteria Chlamydia trachomatis.
The condition occurs worldwide, mostly in rural settings in developing countries. It frequently affects children, although the effects of scarring may not be seen until later in life. While trachoma is rare in the United States, certain populations marked by poverty, crowded living conditions, or poor hygiene are at higher risk for this illness.
Trachoma is spread through direct contact with infected eye, nose, or throat secretions or by contact with contaminated objects, such as towels or clothes. Certain flies can also spread the bacteria.
Symptoms
Symptoms begin 5 to 12 days after being exposed to the bacteria. The condition begins slowly as inflammation of the tissue lining the eyelids (conjunctivitis, or "pink eye"), which if untreated may lead to scarring.
Symptoms may include:
- Cloudy cornea
- Discharge from the eye
- Swelling of lymph nodes just in front of the ears
- Swollen eyelids
- Turned-in eyelashes
Exams and Tests
An eye exam may reveal scarring on the inside of the upper eye lid, redness of the white part of the eyes, and new blood vessel growth into the cornea.
Laboratory tests are needed to accurately identify and detect the bacteria and diagnose trachoma.
Treatment
Antibiotics can prevent long-term complications if used early in the infection. Antibiotics include erythromycin and doxycycline. In certain cases, eyelid surgery may be needed to prevent long-term scarring, which can lead to blindness if not corrected.
Outlook (Prognosis)
Early treatment before the development of scarring and lid deformities has an excellent prognosis.
Possible Complications
If the eyelids are severely irritated, the eyelashes may turn in and rub against the cornea. This can cause eye ulcers, additional scars, vision loss, and possibly, blindness.
When to Contact a Medical Professional
Call your health care provider if you or your child recently visited an area of the world where trachoma is common and there are symptoms of conjunctivitis.
Prevention
Improved sanitation and not sharing items such as towels are important measures for limiting the spread of trachoma.
References
Chidambaram JD, Chandler RD, Lietman TM. Pathogenesis and control of blinding trachoma. In: Tasman W, Jaeger EA, eds. Duane’s Ophthalmology. 15th ed. Philadelphia, Pa: Lippincott Williams & Wilkins; 2009:chap 60.
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
