What is trachoma? It is an infectious eye disease that, if complicated, can cause permanent blindness in the patient. Luckily, there are antibiotics to fight it.

Trachoma is an inflammation of the conjunctiva, which is the mucous membrane that lines the eyeball. In fact, it is caused by the bacterium Chlamydia trachomatis. It is a contagious disease that spreads through the secretions of infected people or by certain flies that feed on the eye fluids of patients.

As indicated by medical studies, trachoma is the leading cause of infectious blindness worldwide. Therefore, detecting its symptoms quickly and effectively is essential to provide the patient with adequate treatment. In fact, here we tell you everything you need to know about this disease.

About its global distribution

We are facing a pathology that is foreign to the western population, but the truth is that it represents a real health problem in many countries. In fact, the World Health Organization (WHO) provides us with certain information about the epidemiology of the disease. Some of them are the following:

  • Trachoma is spread in around 37 countries, causing partial or total visual impairment in 1.9 million people in the world.
  • In areas where the bacterium is endemic, the prevalence (number of affected individuals) in preschool-age children can range from 60% to 90%.
  • Of the total global cases, an estimated 450,000 patients end up with complete and irreversible loss of vision.
  • 158 million people live in regions where this disease is endemic and are at risk of blindness.
  • The worldwide coverage of antibiotics for this pathology is 52%, compared to the 30% reached in 2015.

As we can see, the WHO and other government organizations are fighting against this pathology, but there is still a long way to go. The most affected places are rural areas in Africa, Asia, Central and South America, Australia and the Middle East.

What is trachoma?

As we have already mentioned previously, this pathology responds to an infection by Chlamydia trachomatis, an obligate intracellular parasitic bacterium that affects humans. Not only does it cause this disease, it is also responsible for episodes of pneumonia and pelvic inflammatory diseases.

In fact, according to the Pan American Health Organization (PAHO), repeated infection with C. trachomatis produces internal scars in the upper eyelid, which causes it to retract and the eyelashes rub against the ocular surface, leading to permanent damage to the cornea. It is through this mechanism that the dreaded loss of vision occurs.

Symptoms

According to the American Academy of Ophthalmology (AAO), in its early stages trachoma causes a clinical picture of acute conjunctivitis. The first symptoms appear 5 to 12 days after infection. Some of the most obvious signs of this pathology are the following:

  • Opacity of the cornea, that is, loss of ocular transparency.
  • Ocular discharge
  • Swollen lymph nodes, just in front of the ears.
  • Mild itching and irritation of the eyes.

As the infection becomes more complicated, the eyelid retracts and the consequent appearance of ulcers on the cornea. Studies already cited maintain that a single episode of trachoma does not generate more complications than the symptoms described, but blindness can occur after prolonged exposure to the pathogen.

According to the World Health Organization, this infection can go through five different stages:

Follicular inflammation: first stage of infection. Five or more follicles, which are collections of white blood cells. They can be seen with the appropriate instruments under the upper eyelid.

Intense inflammation: very infectious stage. The eye becomes irritated and there is swelling and thickening in the upper eyelid.

Scarring of the eyelid: repeated infection causes the appearance of white lines (scars) on the upper eyelid that can be seen with the magnifying glass. This leads to a deformation and retraction of the eyelid known as entropion.

Trichiasis: the deformation of the eyelid causes the eyelashes to injure and scratch the ocular surface.

Clouding of the cornea: product of continuous mechanical lesions of the eyelashes on the eye.

Treatment

According to the United States National Library of Medicine, the application of antibiotics in the form of tetracycline or azithromycin ophthalmic ointments can be effective in treating the infection in its earliest stages. In more advanced cases, surgery is required to reorient the eyelid and even a corneal transplant.

Finally, the WHO recommends applying the following strategy to combat trachoma globally. This includes:

  • Surgery for trichiasis.
  • Antibiotics to eliminate Chlamydia trachomatis infection.
  • Facial cleansing as prevention.
  • Environmental improvement to reduce transmission.

Trachoma: what to remember?

As we have seen, we are facing a very contagious disease, typical of rural areas in low-income countries. Despite the success of antibiotic treatment to combat it, many sectors of the population do not have access to them, leading to cases of permanent blindness.

For this reason, it is necessary to maintain disease control and prevention campaigns at a global level. Despite progress, there is still much work you can do to eliminate this pathology from the most disadvantaged sectors of the population.

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