How to Treat Trachoma

Trachoma, also called granular conjunctivitis, is an eye infection caused by the bacteria Chlamydia trachomatis. Trachoma especially affects populations that are living in poverty and areas with crowded living conditions and poor hygiene. Children living in developing countries are more prone to get this type of infection, which is spread through direct contact with an infected eye, nose or throat or with contaminated instruments. Some of the symptoms of trachoma include discharges from the eyes, swelling of the lymph nodes in front of the ears, swollen eyelids, turned-in eyelashes and cloudy corneas.

Significance

• Trachoma is an infection that affects almost 50 million people worldwide, and it is a cause of blindness that is preventable. Women are three times more likely to become blind as a result of trachoma. It is an infection that can affect small communities, hindering groups' abilities to produce economically. Children are the ones that are most susceptible to trachoma because it is spread through contact with hands or clothing.

Early Detection

• Early detection is important in stopping trachoma from becoming more serious. If a person is experiencing itching around the eyes, discharges or some of the other symptoms related to trachoma, they should go to the doctor. It is important to get diagnosis before it leads to scarring of the eyelids. Clouding of the corneas can lead to other severe infections, which in turn can result in ulcers in the cornea and partial or complete blindness. Through magnification processes, physicians are able to better understand the extent of the infection. For example, through magnification of the upper eyelid, doctors are able to look at the white blood cells in the follicles of the eyes to determine whether the infection is at the first level, which is inflammation of the follicles. Doctors can also diagnose trachoma by sending a sample of bacteria from the eyes to be tested in a laboratory.

Medication

• If trachoma is detected early enough, it is treatable with antibiotics. There is no vaccine available, but antibiotics can be effective if the infection is caught in the early stages, which is when people experience corneal inflammation, tearing, light sensitivity and swollen eyelids. Two antibiotics include erythromycin and doxycycline. Other medications that are available are a tetracycline eye ointment and an oral azithromycin known as Zithromax. Although the oral azithromycin has been found to be more effective, one of the biggest issues is that it is more expensive than the ointment. In poorer communities, access to antibiotics and the costs can be two major barriers to getting healthy.

Eyelid Surgery

• Surgery is another treatment, given to those who are experiencing the more severe symptoms of trachoma. One surgery is eyelid rotation surgery, where the doctor moves the eyelids away from the corneas. This surgery is done in order to prevent scarring of the eyelid, and it generally is done on an outpatient basis.

Cornea Grafting

• Another surgery that can be performed is cornea grafting, which is when the corneas are replaced in the eyes. Corneas are the outermost layers in the eyes, or the clear dome-shaped surfaces in the front of the eyes. Corneas have two functions: to protect the eye from germs, dust and other materials and to control and focus the light that comes into the eyes. Cornea grafting is an expensive procedure that is often not available to those who need it. During this procedure, ophthalmologists replace the damaged corneas with donor corneas. One of the biggest problems with this procedure is there is always a chance that corneas will be rejected.

Hygiene

• In order to make sure that trachoma is contained, it is important for people, especially those who live in crowded and rural areas, to practice good hygiene. There is always a chance that someone can get trachoma even after it has been treated. In order to prevent this from happening, groups of people should wash their faces regularly, reduce the fly populations in their areas, find ways to get rid of human and animal waste in their communities in more effective manners and attempt to find cleaner water sources. Creating sanitary conditions can be difficult in some areas, but this has been one of the major reasons that the United States and Morocco no longer have problems with trachoma.