TRACHOMA
By A. Arya raj ,
BAMS FINAL YEAR
Definitions :
Trachoma: A chronic infectious eye
disease caused by Chlamydia trachomatis.
Trachomatous Inflammation, Follicular
(TF): Presence of five or more lymphoid
follicles [small, rounded masses of
lymphoid cells] in the upper tarsal
conjunctiva [membrane covering the
eyelid].
Trachomatous Inflammation, Intense
Trachomatous Scarring (TS): Scarring
of the tarsal conjunctiva [membrane
covering the eyelid], potentially leading to
trichiasis [eyelashes rubbing against the
eyeball] and entropion [eyelid turning
inward].
Trachomatous Trichiasis (TT): Presence
of at least one eyelash touching the globe
[eyeball], causing discomfort and vision
problems.
Corneal Opacity (CO): Corneal
opacification [clouding of the cornea, the
CAUSES:
•Direct or Indirect Contact:
Transmission through direct or indirect
contact with an infected person's hands,
clothing, or other personal items.
• Fly Transmission: Transmission
through flies that come into contact with
the eyes or nose of an infected person.
• Contaminated Water: Transmission
through contaminated water, especially
in areas with poor sanitation and
hygiene.
Signs and Symptoms
~ Active Trachoma: Redness,
inflammation, discharge, and swollen
eyelids.
~ Cicatricial Trachoma: Scarring of the
eyelid and cornea, potentially leading to
trichiasis and entropion, causing
discomfort, vision problems, and
potentially blindness.
~ Trichiasis: Eyelashes rubbing against
the eyeball, causing discomfort, pain, and
vision problems.
~ Entropion: Eyelid turning inward,
STAGING
1. TF: Trachomatous Inflammation, Follicular
[presence of five or more lymphoid follicles in the
upper tarsal conjunctiva].
2. TI: Trachomatous Inflammation, Intense
[pronounced thickening and inflammation of the
conjunctiva].
3. TS: Trachomatous Scarring [scarring of the tarsal
conjunctiva], potentially leading to trichiasis and
entropion.
4. TT: Trachomatous Trichiasis [presence of at least
one eyelash touching the globe], causing
discomfort and vision problems.
5. CO: Corneal Opacity [corneal opacification,
clouding of the cornea].
PATHOPHYSIOLOGY
1. Attachment and invasion of Chlamydia trachomatis.
2. Transformation and multiplication of the bacteria.
3. Immune cell infiltration and inflammatory response.
4. Scarring and complications, potentially leading to
trichiasis and entropion.
Types
Active Trachoma:
Characterized by redness,
inflammation, and
discharge.
Cicatricial Trachoma:
Characterized by scarring of
the eyelid and cornea,
potentially leading to
trichiasis and entropion.
Treatment:
SAFE Strategy: Surgery (trichiasis), Antibiotics (azithromycin,
erythromycin, doxycycline), Facial cleanliness, Environmental
improvement
Surgery to repair advanced disease.
Antibiotics for infections.
Facial cleansing to stop the spread.
Environmental changes like improved access to
clean water and sanitation services.
Surgery:
•In eyelid rotation surgery (bilamellar tarsal
rotation), the doctor makes an incision in the
scarred lid and rotates the eyelashes away from
the cornea. The procedure limits the
progression of corneal scarring and may help
prevent further loss of vision.
•If the cornea has become clouded enough to
seriously impair the vision, corneal
transplantation may be an option that could
improve vision.
•One may have a procedure to remove
eyelashes (epilation) in some cases. This
A CHRONIC CONTAGIOUS
CONJUNCTIVITIS MARKED BY
INFLAMMATORY GRANULATIONS ON
THE CONJUNCTIVAL SURFACES,
CAUSED BY A BACTERIUM OF THE
GENUS CHLAMYDIA (C.
TRACHOMATIS), AND COMMONLY
RESULTING IN BLINDNESS IF LEFT
UNTREATED.
ANY
DOUBTS ?
THANK YOU
