Trachoma

Trachoma is a bacterial eye infection caused by Chlamydia trachomatis, spread through contact with eye or nose discharge from an infected person, often via hands, flies, or shared cloths. Repeated infection over years can cause the eyelid to turn inward, scarring the cornea and causing blindness.

• Early infection: redness, irritation, and watery or mucopurulent discharge from the eyes, often affecting both eyes
• Repeated infection over years can lead to scarring inside the eyelid, causing the eyelashes to turn inward and rub against the eye (trichiasis)
• This constant rubbing damages the clear surface of the eye (cornea), which can progress to visual impairment or blindness if untreated

• Caused by the bacterium Chlamydia trachomatis.
• Spread through direct or indirect contact with eye or nose discharge from an infected person — via hands, shared towels or cloths, or flies that have had contact with an infected person's face.
• Risk is increased by limited access to water for washing, poor facial hygiene, especially in young children, and crowded living conditions.

• Diagnosed clinically by examining the inner surface of the upper eyelid for characteristic follicles or scarring, using eyelid eversion and, where available, magnification.
• Community-level trachoma surveys use a standardised grading system to assess the stage of disease and guide public health response.
• Advanced disease is identified by looking for inward-turning eyelashes (trichiasis) and corneal clouding.

Active trachoma infection is treated with a single oral dose of azithromycin, which is also used for mass treatment of communities in endemic areas as part of trachoma elimination programmes, alongside topical tetracycline eye ointment as an alternative for individual treatment.

Established trichiasis (inward-turning eyelashes) requires a minor eyelid surgery to correct the position of the eyelashes and prevent further corneal damage — medicine alone cannot reverse this stage.

Public health control also includes promoting facial cleanliness and environmental improvements such as better access to water and reducing fly populations.

• Wash the face regularly, especially in young children, to reduce eye and nose discharge that can spread infection.
• Improve access to clean water for washing.
• Reduce fly populations through proper waste and animal waste disposal.
• Avoid sharing towels or cloths used to wipe the face.
• Support community mass treatment and screening campaigns in known endemic areas.