Trachoma is a chronic conjunctivitis caused by repeated infection of Chlamydia trachomatis. It causes inflammation of the conjunctiva and scarring of the tarsal plate, which can turn the eyelashes inward rubbing on the cornea and causing blindness. It is transmitted through direct contact with eye discharge or flies/fingers and occurs more commonly in areas with poor sanitation and water access. Signs include eye discharge, swollen eyelids, and trichiasis. Treatment involves antibiotics and surgery, while prevention focuses on education, improved sanitation, and reducing risk factors.
2. It is a chronic conjunctivitis due to repeated
infection with Chlamydia trachomatis, serotypes
A, B, and C.
Trachoma
3. Conjunctiva:
It is the clear mucous membrane covering
the sclera (white part of eye) and interior lining of
eyelids .
It contains many goblet cells which secrets
mucin that keep the eye moist.
Conjunctivitis:
Conjunctivitis is the inflammation of the
conjunctiva.
The inflammation of the conjunctiva cause
the eye’s blood vessels to dilate, resulting in
the reddish appearance.
Quick review:
4. Inflammation from active trachoma infection
tarsal plate scarring
eyelashes to turn in.
The lashes rub on the cornea, producing
ulceration, scarring, and blindness
Pathophysiology:
5. Eye discharge
Swollen eyelids
Trichiasis (turned-in eyelashes)
Swelling of lymph nodes in front of the ears
Sensitivity to bright lights
Increased heart rate
Further ear, nose and throat complication
Sign & symptoms:
6. The disease usually occur at :
poor dry areas of the world in which there is
inadequate water supply and poor community
sanitation.
poverty , crowding
Most transmission of trachoma occurs within the
family.
Mode of transmission:
7. Flies: flies go from individual to individual
Fingers: direct contact with ocular discharge
Family: within the family, child to child
3 Fs for transmission:
8.
9. Trachoma Stages
Normal Conjunctiva
(as described earlier )
Trachomatous inflammation follicular
(TF): the presence of five or more
follicles(round swellings that are paler
than the surrounding conjunctiva) in the
upper tarsal conjunctiva.
Trachomatous inflammation intense
(TI): Obvious inflammatory thickening of
the tarsal conjunctiva that obscures more
than half of the normal deep tarsal
vessels.
10. Trachoma Stages cnt
Trachomatous scarring (TS): the
presence of scarring in the tarsal
conjunctiva. Scars are easily
visible as white lines, bands, or
sheets in the tarsal conjunctiva.
Trachomatous trichiasis (TT): at
least one eyelash rubs on the
eyeball.
Corneal opacity (CO): easily
visible corneal opacity over the
pupil. The pupil margin is blurred
viewed through the opacity.
11. Antibiotics : Azithromycin
Surgery : A bilamellar tarsal rotation procedure
is warranted to direct the lashes away from the
globe.Early intervention is beneficial as the rate of
recurrence is higher in more advanced disease.
Lifestyle measures
Treatment:
12. Educate the public
Improve basic sanitation
Provide adequate case finding and treatment
facilities; with emphasis on preschool children.
Improving life style measure
Preventing complication
Avoiding risk factor
Prevention: