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Trachoma

This article provides a straightforward overview of the causes, symptoms, diagnosis, treatment, and prevention of trachoma, a contagious bacterial infection of the eyes.

Causes:

Chlamydia trachomatis, specifically serotypes A, B, Ba, and C, causes trachoma. Infection occurs when you come into contact with discharge from an infected individual's eyes or nose, usually through close personal contact, contact with contaminated hands or objects, or through flies that have come into contact with infected secretions.

Symptoms:

Trachoma may cause the following symptoms:

  • An inflammation of the conjunctiva is characterized by redness, swelling, and irritation of the thin membrane covering the inner surface of the eyelids and the whites of the eyes.

  • When you wake up in the morning, your eyes are discharged with mucus or pus.

  • Thickening or scarring of the eyelids, particularly the upper eyelids, as a result of repeated inflammation and healing episodes.

  • Inflammation of the conjunctiva or cornea can cause photophobia.

  • Reduction in visual acuity or blurry vision, especially when corneal scarring or opacity are present in advanced stages of trachoma.

Diagnosis:

Typically, trachoma is diagnosed through a combination of clinical evaluation, laboratory testing, and eye examination. Diagnostic procedures may include:

  • The healthcare provider will examine the eyes for typical signs of trachoma, such as inflammation, discharge, eyelid changes, and corneal opacity.

  • Conjunctival discharge samples can be collected using a swab and tested for Chlamydia trachomatis bacteria using laboratory tests such as polymerase chain reaction (PCR) or direct fluorescent antibody (DFA).

  • A slit lamp microscope may be used to examine the cornea for scarring or opacity, which may indicate advanced trachoma and potential vision loss.

Treatment:

The goal of treatment for trachoma is to eliminate the bacterial infection, reduce inflammation, and prevent complications such as corneal scarring and blindness. Treatment options include:

  • Azithromycin, tetracycline, or erythromycin may be prescribed to eradicate Chlamydia trachomatis bacteria and reduce inflammation.

  • Clean your eyelids gently with saline solution or mild soap to reduce discharge and prevent secondary bacterial infections.

  • To prevent blindness and improve vision in cases of advanced trachoma with corneal scarring or entropion (inward turning of the eyelids), surgical intervention such as trichiasis surgery or corneal transplantation may be required.

Prevention:

In order to prevent trachoma, public health measures must be implemented to control transmission of the bacteria and reduce the prevalence of the disease. Examples of prevention strategies include:

  • In communities with high trachoma prevalence, promoting good hygiene practices like face washing with clean water and soap can reduce transmission.

  • Improved access to clean water and sanitation facilities, especially in resource-limited settings, can help reduce the transmission of trachoma.

  • Using insecticide-treated bed nets or fly traps can reduce the spread of trachoma by flies by implementing fly control measures.

  • It has been demonstrated that mass drug administration (MDA) of antibiotics to entire communities at risk for trachoma, particularly azithromycin, can reduce the prevalence of infection and prevent the spread of the disease.

  • Trachoma education and community outreach programs can assist individuals and communities in taking proactive measures to control the disease by raising awareness about trachoma, its transmission, and prevention strategies.

 

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