Overview
Understanding the disease
Risk Factors
Risk factors for developing trachoma include crowded living conditions, poor sanitation, living in close contact with infected individuals, poor hygiene practices, being in areas where the disease is active, and having inadequate access to water. Trachoma is more common in children ages 4 to 6 and women may be more susceptible due to their increased contact with children, who are the primary reservoir of infection. Living in areas with problems controlling the fly population can also increase the risk of infection.
Development
Trachoma progresses through five stages of development, as identified by the World Health Organization (WHO). The stages are:
- Inflammation - follicular: In the early stage of infection, there are five or more follicles visible with magnification on the inner surface of the upper eyelid.
- Inflammation - intense: In this stage, the eye becomes highly infectious and the upper eyelid becomes irritated and swollen.
- Scarring: In this stage, scarring of the eyelid tissue occurs, which can lead to the eyelashes turning inward (trichiasis). This makes the eyelashes rub against the cornea, causing pain, inflammation, and potential vision loss.
- Corneal opacification: In this stage, the cornea becomes cloudy due to inflammation and scarring, which can lead to vision loss.
- Late stage trichiasis: In the final stage, the eyelashes continue to turn inward, causing painful corneal abrasion and potentially leading to blindness. It's important to note that the progression of trachoma can vary between individuals and depends on factors such as age, hygiene, and access to healthcare. Early treatment with antibiotics can help prevent the development of complications.
Assessment and Diagnosis
Management and Treatment
Complications
Potential complications of trachoma include scarring of the inner eyelid, which can lead to trichiasis. Trichiasis occurs when the eyelashes turn inward and touch the cornea, causing pain and potentially leading to blindness. Untreated trachoma can also result in corneal opacities and vision loss.
Treatment
There are two main treatments for trachoma: antibiotics and surgery. Antibiotics: The most common antibiotic used for treating trachoma is tetracycline. Azithromycin, doxycycline, and erythromycin can also be used in certain cases. Antibiotics help to eliminate the bacterial infection and prevent further complications, such as scarring of the inner eyelid or eyelid deformities. Surgery: If antibiotics are ineffective or if the disease has progressed to a severe stage, surgery may be necessary. Two common surgeries used to treat trachoma are:
- Tarsorrhaphy: This surgical procedure involves cutting the outer corner of the eyelid to close the eyelid, reducing the amount of eye exposure and thus preventing further infection.
- Entropion repair: In this surgery, the inward-folding eyelid (entropion) is corrected to prevent the eyelashes from scratching the cornea. It's important to follow up with your healthcare provider after treatment to ensure that the infection has been effectively managed and to monitor for any potential complications.