Trachoma is the most common infectious cause of blindness in the world caused by recurrent ocular surface infection and secondary scarring by the bacterial organism Chlamydia trachomatis.
Repeat infection with this organism leads to conjunctival inflammation and scarring, trichiasis, and ultimately blinding corneal opacification and thus a leading cause of preventable blindness.
Four ocular serotypes of Chlamydia trachomatis: A, B, Ba and C have been implicated.
RISK FACTORS:
-Endemic geographical regions: parts of North Africa, Middle East, North west India and parts of Southeast Asia.
-Limited environmental and social hygiene resources
-Inadequate water supply with less water available to use for facial cleansing, breeding and transmission of flies that may help spread disease
-Poor facial hygiene: secretions around the eye attracts flies that are physical vectors for C. trachomatis transmission
-Overcrowded Living Conditions
MANAGEMENT:
• S: Surgery for Trichiasis
• A: Antibiotics for C. trachomatis infection
• F: Facial cleanliness
• E: Environmental change to improve sanitation and increase access to clean water.
-Prevention is ideally the best strategy which includes hygiene, public education coupled with increased awareness.
-Azithromycin and even topical Azithromycin used twice daily for 3 days
-Supportive treatment: lid and ocular surface hygiene, aggressive lubrication and antibiotics for secondary infections.
-SURGICAL: redirect eyelashes and eyelid margin away from the cornea.
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Image from Rajan Eye Care Hospital
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