By ULY CLINIC

Trachoma

Introduction

It is a chronic conjunctivitis caused by infection with Chlamydia trachomatis (bacteria). It is one of the commonest causes of blindness worldwide. There is a chronic inflammation of the conjunctiva leading to scarring of the upper eyelid tarsal plate, entropion and in turn of eyelashes.

Diagnostic Criteria

Patients presents with photophobia in early stages or re-infection
Follicles in the upper tarsal plate seen as round and white nodules in active diagnostic.
In late stages, in-turned eyelashes rub on the cornea leading to corneal ulcers
Loss of vision due to Corneal scarring.

Clinical Stages

Clinical Stages according to World Health Organization

Trachomatous Inflammation Follicular (TF) - Presence of at least 5 follicles on the upper tarsal plate
Trachomatous Inflammation Intense (TI) – There is intense inflammation, the conjunctival blood vessels cannot be seen.
Trachomatous Scarring (TS) – Presence of white scars in the upper tarsal plate
Trachomatous Trichiasis (TT) – Presence of some eye lashes rubbing against the cornea
Corneal Opacity (CO) – Presence of corneal opacity (scar) affecting the central cornea

Non-Pharmacological Treatment

Face washing and total body hygiene to prevent transmission of disease from one person to the other
Environmental improvement/hygiene

Pharmacological Treatment

Oxytetracycline ointment 3% once a day for 6 weeks

Azithromycin 1g as a single dose for adults- for preventive chemotherapy in mass treatment campaign

Dosage of azithromycin in children

Note: Preventive chemotherapy in mass treatment campaign is conducted only once a year Surgery Surgical correction of entropion in TT patients. This procedure can be done at a Dispensary or Health Centre and community level by a trained health worker.

Updated on, 2.11.2020

References

1. STG

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