What is Trachoma?

Trachoma is an infection of the eyes by Chlamydia trachomatis and is the leading cause of preventable blindness. Although the control over trachoma is very well in developed nations, in overcrowded regions with limited access to clean water and healthcare, this infection is abundant.

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Trachoma can be characterized by discharge from the eyes and repeated infections that tend to cause the eyelashes to curl into the eye. This can lead to scratching of the cornea, blurred vision, and eventually loss of vision.

Epidemiology

Blinding trachoma remains endemic in 51 countries, particularly in the poorest and most remote areas of these regions. The most common countries to be affected by trachoma can be found in Africa, Asia, Central and South America, as well as both Australia and the Middle East.

It is estimated that over 21 million people worldwide have active trachoma, with 2.2 and 1.2 million people who are visually impaired and blind due to this infection, respectively. Africa is considered to be the worst affected continent by trachoma, with over 18 million cases that are currently active in this area of the world, which accounts for over 85% of all cases globally.

The World Health Organization (WHO) estimates that 6 million people are blind due to trachoma on a global basis. Additionally, in excess of 150 million people need treatment to prevent blindness in the future.

Causes

The infectious bacteria that is secreted from the eyes of someone suffering from the condition can be passed on to other people via direct contact, clothing, or flies that transport the bacteria.

It is particularly prevalent in poverty-stricken and rural regions that do not have access to fresh, clean water. This is due to the infection being spread through the water supply and the access facilities.

Symptoms

The initial infection of trachoma usually occurs in childhood and repeated infections cause the condition of the eyes and vision to worsen gradually.

The most prominent symptom of an acute infection is discharge from the eye. Additional symptoms of trachoma may include a cloudy cornea and/or swelling of the eyelids and lymph nodes.

After several repeated infections, the eyelashes turn in against the eye and rub against the cornea. This results in scarring of the eye and blurred vision and, in severe cases, blindness.

Prevention

As trachoma is an infectious disease that is common in regions with poor sanitation, many actions can be taken to prevent the condition and related complications.

WHO has committed to eliminating blindness caused by trachoma worldwide by 2020, using the SAFE strategy. This includes:

  • Surgery when necessary
  • Antibiotics to eradicate infection
  • Facial cleanliness promotion to prevent the spread of infection
  • Environmental improvement, such as increasing the availability of water facilities

This approach includes eradicating active infections from individuals with antibiotics to prevent the spread of the infection, in addition to several environmental aspects.

The provision of clean water to encourage regular face washing, for example, can help to reduce infection,. Both improved sanitation and reducing breeding sites of flies can also prevent the spread of the infection.

The battle to eliminate the devastating eye disease trachoma

Treatment

The antibiotic azithromycin offers an ideal solution to active trachoma infection. It is available as a single oral dose that can easily be distributed and, thus far, antibiotic resistance has not posed as an issue. Azithromycin has few side effects, is cost-effective, and works very well to eradicate trachoma infection.

Patients who have had numerous trachoma infections may be at risk of visual impairment or blindness due to the turning in of the eyelashes. Trichiasis surgery can be performed to reverse the direction of the eyelashes and simply prevent the deterioration of sight. This also offers the added benefit of a higher quality of life for the individuals.

With the implementation of these treatment and prevention methods, the prevalence of trachoma has the potential to fall dramatically worldwide. This will help millions of people to maintain their vision and allow them to live a higher quality of life that is uninhibited by blindness or clouded vision.

References

Further Reading

Last Updated: Apr 6, 2021

Yolanda Smith

Written by

Yolanda Smith

Yolanda graduated with a Bachelor of Pharmacy at the University of South Australia and has experience working in both Australia and Italy. She is passionate about how medicine, diet and lifestyle affect our health and enjoys helping people understand this. In her spare time she loves to explore the world and learn about new cultures and languages.

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