Trachoma (truh-KOH-muh) is a bacterial infection that affects your eyes. It's caused by the bacterium Chlamydia trachomatis. Trachoma is contagious, spreading through contact with the eyes, eyelids, and nose or throat secretions of infected people. It can also be passed on by handling infected items, such as handkerchiefs.
At first, trachoma may cause mild itching and irritation of your eyes and eyelids. Then you may notice swollen eyelids and pus draining from the eyes. Untreated trachoma can lead to blindness.
Trachoma is the leading preventable cause of blindness worldwide. Most trachoma cases occur in poor areas of Africa, where 85% of people with active disease reside. In areas where trachoma is prevalent, infection rates among children under 5 can be 60% or more.
Early treatment may help prevent trachoma complications.
Signs and symptoms of trachoma usually affect both eyes and may include:
Young children are particularly susceptible to infection. But the disease progresses slowly, and the more painful symptoms may not emerge until adulthood.
The World Health Organization (WHO) has identified five stages in the development of trachoma:
All the signs of trachoma are more severe in your upper lid than in your lower lid. Without intervention, a disease process that begins in childhood can continue to advance into adulthood.
Call your doctor if you or your child has itchy or irritated eyes or discharge from the eyes, especially if you live in or recently traveled to an area where trachoma is common. Trachoma is a contagious condition. Treating it as soon as possible helps prevent serious infection.
Trachoma is caused by certain subtypes of Chlamydia trachomatis, a bacterium that can also cause the sexually transmitted infection chlamydia.
Trachoma spreads through contact with discharge from the eyes or nose of an infected person. Hands, clothing, towels and insects can all be routes for transmission. In developing countries, eye-seeking flies also are a means of transmission.
Factors that increase your risk of contracting trachoma include:
One episode of trachoma caused by Chlamydia trachomatis is easily treated with early detection and use of antibiotics. Repeated or secondary infections can lead to complications, including:
If you've been treated for trachoma with antibiotics or surgery, reinfection is always a concern. For your protection and for the safety of others, be sure that family members or others you live with are screened and, if necessary, treated for trachoma.
Trachoma can occur worldwide but is more common in Africa, Asia, Latin America, the Middle East and the Pacific Rim. When in regions where trachoma is common, take extra care in practicing good hygiene, which can help prevent infection.
Proper hygiene practices include:
No trachoma vaccine is available, but prevention is possible. The WHO has developed a strategy to prevent trachoma, with the goal of eliminating it by 2020. While the goal hasn't been entirely achieved, trachoma cases have declined sharply. The strategy, titled SAFE, involves:
Your doctor can diagnose trachoma through a physical examination or by sending a sample of bacteria from your eyes to a laboratory for testing. But lab tests aren't always available in places where trachoma is common.
Trachoma treatment options depend on the stage of the disease.
In the early stages of trachoma, treatment with antibiotics alone may be enough to eliminate the infection. Your doctor may prescribe tetracycline eye ointment or oral azithromycin (Zithromax). Azithromycin appears to be more effective than tetracycline, but it's more expensive.
The World Health Organization (WHO) recommends giving antibiotics to an entire community when more than 10% of children have been affected by trachoma. The goal of this guideline is to treat anyone who has been exposed to trachoma and reduce the spread of trachoma.
Treatment of later stages of trachoma — including painful eyelid deformities — may require surgery.
In eyelid rotation surgery (bilamellar tarsal rotation), your doctor makes an incision in your scarred lid and rotates your eyelashes away from your cornea. The procedure limits the progression of corneal scarring and may help prevent further loss of vision.
If your cornea has become clouded enough to seriously impair your vision, corneal transplantation may be an option that could improve vision.
You may have a procedure to remove eyelashes (epilation) in some cases. This procedure may need to be done repeatedly.
You're likely to start by seeing your primary care doctor if you or your child has symptoms of trachoma. Or you may be referred immediately to an eye specialist (ophthalmologist). When you make the appointment, ask if you need to do anything in the meantime, such as keeping your child home from school or child care.
Here's some information to help you get ready for your appointment.
Before your appointment make a list of:
For eye irritation, some basic questions to ask your doctor include:
Your doctor is likely to ask you a number of questions, such as:
While you are waiting for your appointment, practice good hygiene to reduce the possibility of spreading your condition by taking these steps:
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