What is Trachoma?

Trachoma is an infection of the eyes by Chlamydia trachomatis and is the leading cause of preventable blindness. Although it is very well in developed nations, in overcrowded regions with limited access to clean water and healthcare it is abundant.

It is characterized by discharge from the eyes and repeated infections tend to cause the eyelashes to curl into the eye. This can lead to scratching of the cornea, blurred vision and eventually loss of vision.

Epidemiology

Trachoma is endemic in 57 countries and affects 40.6 million people, according to statistics from 2009. It accounts for 1 in 20 of global cases of blindness and is a significant public health issue, particularly given the complications such as blindness that can occur.

The World Health Organisation estimates that six million people are blind due to trachoma on a global basis. Additionally, in excess of 150 million people need treatment to prevent blindness in the future.

Causes

The infectious bacteria that is secreted from the eyes of someone suffering from the condition can be passed on to other people via direct contact, clothing or flies that transport the bacteria.

It is particularly prevalent in poverty-stricken and rural regions that do not have access to fresh, clean water. This is due to the infection being spread through the water supply and the access facilities.

Symptoms

Initial infection usually occurs in childhood and repeated infections cause the condition of the eyes and vision to worsen gradually.

The most prominent symptom of an acute infection is discharge from the eye. All symptoms may include:

• Eye discharge
• Cloudy cornea
• Swelling of eyelids and lymph nodes

After several repeated infection, the eyelashes turn in against the eye and rub against the cornea. This results in scarring of the eye and blurred vision and, in severe cases, blindness.

Prevention

As trachoma is an infectious disease that is common in regions with poor sanitation, many actions can be taken to prevent the condition and related complications.

The world health organization has committed to eliminate blindness caused by trachoma worldwide by 2020, using the SAFE strategy. This includes:

• Surgery when necessary
• Antibiotics to eradicate infection
• Facial cleanliness promotion to prevent spread of infection
• Environmental improvement, such as available water facilities

This approach includes eradicating active infections from individuals with antibiotic to prevent the spread of the infection, in addition to several environmental aspects.

The provision of clean water to encourage regular face washing can help to reduce infection, as well as improved sanitation and reducing breeding sites of flies, which can also spread the infection.

Treatment

The antibiotic azithromycin offers an ideal solution to the active trachoma infection. It is available as a single oral dose that can easily be distributed and, thus far, antibiotic resistance has not posed as an issue. It has few side effects, is cost-effective and works very well to eradicate the infection.

Patients that have had numerous infections may be at risk of visual impairment or blindness due to the turning in of the eyelashes. Trichiasis surgery can be performed to reverse the direction of the eyelashes and simply prevent the deterioration of sight. This also offers the added benefit of a higher quality of life for the individuals.

With the implementation of these treatment and prevention methods, the prevalence of trachoma has the potential to fall dramatically worldwide. This will help millions of people to maintain their vision and allow them to live a higher quality life, uninhibited by blindness or clouded vision.

References

• http://www.who.int/water_sanitation_health/diseases/trachoma/en/
• http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)62182-0/fulltext
• http://www.ncbi.nlm.nih.gov/pubmed/19496626?dopt=Abstract
• http://www.nlm.nih.gov/medlineplus/ency/article/001486.htm
• http://www.patient.co.uk/pdf/2887.pdf

Further Reading

• All Trachoma Content

Written by

Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.