TRACHOMA

Trachoma

A chronic, bilateral infectious, cicatrizing, keratoconjunctivitis.

The disease occurs under living conditions with poor hygiene;
especially where there is little washing, dirt, and flies, so that
the infection is passed from eye to eye (ocular transmission).
A second type of trachoma infects the epithelium of the genital
tract and may be transmitted venerially.

Causative organism - Chlamydia Trachomatis.

Three clinical stages are-
1. The stage of infiltration - a simple conjunctivitis without any
macroscopic differentiating features. The onset may be acute
after an incubation period of about five days. If there is a secon-
dary infection, oedema of the lid, and discharges, are prominent.

2. Stage of active inflammation with diagnostic appearance of
papillae and follicles especially involving the upper tarsal plate.
A vascular and cellular infiltration of the corneal epithelium
(pannus) characteristically spreads from the upper arc of the
limbus.

3. Stage of scarring - scars lead to shrinkage of the conjunctiva
and particularly of th eupper eye lid (entropion). Time factor varies
from months to few years. As a reservoir of infection persists in the
community, reinfections and exacerbations are common.

Complications:
- conjunctival scarring and shrinkage
- corneal scarring
- entropion of lid margins causing trichiasis, corneal ulceration and
further scarring
- ptosis
- xerosis
- blindness

Treatment: should be both medical and social (if possible)
medications - Sulphonomides (Septrim, Bactrim) or tetracycline
orally, and tetracycline eye ointment topically.

Environmental improvement will reduce the rate of transmission and
re-infection.

Attempts should be made to improve personal hygiene and sanitation.