Trachoma is the leading cause of preventable blindness caused by an infectious disease. It is spread by direct contact with people, objects, or flies carrying Chlamydia trachomatis. Blindness occurs due to corneal scarring with repeated infections (severe scaring of the eyelid-->eyelid inversion-->repeated corneal abrasions).
Clinical Presentation:
-Mild: Hypopigmented follicles on the inner eyelid; Moderate: inner eyelid scarring/eyelash inversion; Severe: corneal scarring/blindness (irreversible)
Diagnosis:
- Clinical: eyelid eversion and careful examination looking for the above
Treatment:
- Azithromycin 20mg/kg ONE TIME DOSE (preferred)
- 1% Tetracycline ointment bid x6 weeks
- If scarring or eyelid inversion is present, surgery is needed.
Bottom Line:
Trachoma is a clinical diagnosis and easy to treat early with a single dose of antibiotics. Patients with late findings should be referred for surgery.
University of Maryland Section of Global Emergency Health
Author: Andi Tenner, MD, MPH, FACEP
References
Trachoma control: a guide for programme managers. World Health Organization. 2006. Accessed on 16 Oct 2013 at: http://www.who.int/blindness/publications/tcm%20who_pbd_get_06_1.pdf
