Consultant Ophthalmic Surgeon, Shroff Eye Centre, New Delhi
Trachoma is one of the oldest infection known to man and the leading cause of preventable blindness in the world, affecting over 400 million people. It is responsible for about 5% of blindness and visual impairment in India. The disease usually begins in early childhood, but does not cause blindness until much later in life.
What is trachoma?
Trachoma is an infection of the eye which, if untreated, leads to blindness. It is caused by the organism Chlamydia trachomatis. The infection begins slowly as a mild conjunctivitis, an inflammation of the conjunctiva. The conjunctiva is the thin layer covering the front of the eye and the inside of the eyelids. The initial stage lasts several weeks and is followed by the chronic stage in which there is irritation and scarring of the eyelids. The scarring eventually causes the eyelids and lashes to turn inwards, rubbing and damaging the cornea, the central transparent potion of the eye. It is this corneal scarring which leads to severe vision loss and blindness.
What are its causes?
Trachoma is an infection passed from one person to another through the discharge from the eyes of an infected individual. The infection is passed to others by hands, clothing and towels, or by flies. Areas with overcrowding, poor sanitation and lack of clean water have a higher incidence of trachoma. Direct sunlight, dust, smoke and irritants such as kajal or surma predispose to infection. Women and children are more prone to severe trachoma infection.
What are its symptoms?
The symptoms of trachoma include:
Irritation, swelling and scarring of eyelids
Pus-like discharge from the eye
Swelling of lymph nodes just in front of the ears
Loss of vision and blindness
How is it diagnosed?
Diagnosis mainly relies on examination and symptoms. However, to confirm the infection the doctor may suggest lab tests including polymerase chain reaction (PCR) and enzyme immunoassay (EIA) of conjunctival smears.
What is the treatment?
The best time to treat trachoma is during childhood, before serious damage has begun. Early treatment result in full recovery and prevents loss of vision or blindness. Trachoma can be easily treated with antibiotic ointments like tetracycline or sulfonamides. Oral erythromycin also helps to treat the infection. The doctor may advise surgery to repair the damaged and scarred eyelids.
How can it be prevented?
One of the best ways to prevent trachoma is to wash the face and eyes frequently with clean water. Increased sanitation and education about the disease also help in decreasing its spread.