[Gr. trachōma, roughness]
A chronic, contagious form of bacterial conjunctivitis that is the leading cause of contagious blindness worldwide.
Trachoma is caused by ocular infection with the bacterium Chlamydia trachomatis. It is transmitted by contact with the clothing, bedding, or hands of other people contaminated by infectious exudate. In endemic regions, flies serve as a vector for the disease.
The disease is endemic in Africa, India, and the Middle East and is seen also in the southwestern U.S. It is more commonly diagnosed in economically depressed populations, esp. children living in poverty.
SYMPTOMS AND SIGNS
Approx. 5 days to 2 weeks after direct contact with infected ocular secretions, pink eye (ocular inflammation) develops. Over several years inflammation of the eyelids occurs, causing the eyelashes to rub against the cornea, a painful condition known as trichiasis. This is followed by gradual and progressive scarring, which causes the normally clear cornea of the eye to become opaque, eventually leading to blindness.
In communities where trachoma is prevalent, the diagnosis is often made on clinical examination alone. When the diagnosis is in doubt, conjunctival swabs can be sent to the laboratory for microbiological culturing.
The spread of trachoma can be prevented by communities with solid waste management strategies that limit the proliferation of flies. Infected people should be treated promptly with antibiotic therapy to prevent person-to-person spread of the disease. Careful laundering of infected towels and clothing, frequent handwashing, and daily facial washing in endemic communities are also promoted by the WHO.
Oral azithromycin is the drug of choice. Topically applied tetracyclines are an alternative antibiotic therapy. Advanced eyelid scarring can be treated surgically. Corneas that are clouded over by years of scarring may require corneal transplantation.
IMPACT ON HEALTH
With prompt and appropriate antibiotic therapy, the infection clears quickly without adverse consequences.
Although there are no vaccines against trachoma, travelers to endemic areas should promptly seek care for symptoms of pink eye, avoiding sharing personal items with other people, and wash their hands and faces frequently.
SYN: SEE: Egyptian ophthalmia; SEE: granular conjunctivitis
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