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Health Knowledge and Encyclopedia
At your local Pearn's Pharmacy we can offer advice on most general health matters. You can also use our Health Encyclopaedia to provide you with the tools and links you need to pinpoint symptoms and get a full explanation of a suspected condition.
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Trachoma is a type of bacterial eye infection. The condition is a leading cause of premature blindness worldwide, although it's now rare in developed nations, such as the UK.
How trachoma is spread
Trachoma is caused by a type of bacteria called Chlamydia trachomatis, which can be highly contagious.
Someone can become infected if they come into direct contact with the eye discharge produced by an infected person, or by contact with contaminated objects, such as towels and clothes.
Flies can also spread the infection. In the developing world, flies are one of the main ways that trachoma is spread.
Due to the fact that trachoma is so easily spread, many people are repeatedly infected and the risk of blindness increases with each infection.
Read more about what causes trachoma
Who is affected by trachoma?
Trachoma is a disease directly related to poverty. Trachoma was common during the 19th century, but due to improvements in health and hygiene, the condition is no longer a problem in England and Wales and the rest of the developed world (with the exception of some Aboriginal communities in Australia).
Nowadays, trachoma is usually only found in the very poorest communities – typically villages and slums in hot, dusty climates where hygiene levels are poor and access to water and sanitation is limited. The majority of trachoma cases occur in Africa and the Middle East.
It's estimated that more than 80 million people have an active trachoma infection and 1.3 million people are blind as a result of repeated trachoma infections.
Trachoma is most common in children who are between one and five years old. In adults, women are more likely than men to develop trachoma because they tend to be in closer contact with young children.
Read more about the risk factors for trachoma.
Trachoma is simple to treat. However, as people with trachoma tend to live in areas where the condition is widespread, the risk of re-infection is high. Therefore, treatment for trachoma is focused on the community rather than on the individual.
The World Health Organization (WHO) has recommended a community-focused treatment plan called SAFE. This stands for:
The aim of the World Health Organisation (WHO) is to eliminate trachoma everywhere in the world by 2020. Read more about WHO-led initiatives to prevent blindness and visual impairment.
Advice for travellers
Travellers from England and Wales are only at risk of developing trachoma if they're planning to live or work in very poor communities in the developing world – for example, as aid workers.
However, even if someone living and working in a community where trachoma is a problem were to develop the infection, it's highly unlikely that they would have the repeated infections that can cause blindness.
The initial symptoms of trachoma include:
If a person has repeated trachoma infections, their symptoms can become more severe. Symptoms caused by repeated infection inlcude:
As the condition progresses, the ‘turned in’ eyelashes will begin to scar the cornea (the transparent layer at the front of the eye). The scarring will cause a person’s vision to become increasingly cloudy and, left untreated, it will eventually lead to a complete loss of vision.^^ Back to top
Trachoma is caused by bacteria called Chlamydia trachomatis, which is a similar bacterium to the one that causes the sexually transmitted infection, chlamydia.
The bacteria cause the follicles in the eyelids to become inflamed (red and swollen). Follicles are small sacs in the skin from which the eyelashes grow.
A single infection does not pose any serious threat to the eyes, but repeated infections can cause extensive inflammation and scarring of the eyelids.
Extensive scarring results in a deformity of the eyelids, causing the eyelashes to turn inwards and scratch the surface of the eyes. The scratching causes the cornea (transparent layer at the front of the eye) to become scarred, which can result in a partial loss of vision, followed by a total loss of vision.
How trachoma is spread
After a person is infected by the bacteria, their eyes, and in some cases their nose, produce a discharge that contains the bacteria. The discharge can be spread to other people's eyes by:
Environmental risk factors
Trachoma thrives in hot, dry and dusty environments where:
Trachoma can usually be diagnosed by visually examining a person’s upper eyelids.
If there's any doubt, further tests can be carried out by taking a sample of discharge and testing it for the presence of the Chlamydia trachomatis bacteria.
Due to the highly contagious nature of trachoma, an entire community will be treated to stop it from spreading.^^ Back to top
The World Health Organization (WHO) recommends carrying out an initiative called ‘SAFE’. SAFE stands for:
Environmental changes and face washing
Regular face washing is very important because it removes the contagious discharge produced by the infection and reduces the chances of the infection being spread through physical contact and flies. However, people are often reluctant to wash their faces regularly if clean water is limited.
Therefore, environmental improvements usually focus on the following three factors:
Even simple improvements to an environment can help reduce the spread of trachoma. For example, digging latrine pits (toilets in the ground) can help to reduce the fly population.
As many of the countries affected by trachoma are very poor, much of the environmental improvement work is done by charities, voluntary organisations and other non-governmental organisations (NGOs), such as:
Both antibiotic lotions (topical antibiotics) and tablets (oral antibiotics) can be used to treat trachoma.
In communities where trachoma is widespread, it's usually necessary to treat the whole community to prevent re-infection. The WHO recommends that if 10% or more of the children in a community have trachoma, everyone in the community should be treated with antibiotics once a year for three years.
Eyelid rotation surgery can be used in cases of trachoma where scarring to the eyelids is causing the eyelashes to turn inwards. During surgery, an incision is made in the upper eyelid and the eyelashes are rotated away from the cornea.
The surgery is relatively straightforward and it can be carried out under local anaesthetic (painkilling medication). The procedure only takes around 15 minutes to complete.
In cases of visual impairment, it may be possible to restore some vision by removing the damaged corneas and replacing them with transplanted corneas. However, access to this type of surgery is usually unavailable in places where trachoma is widespread.^^ Back to top
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