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  Trachoma

Trachoma comes from ancient Greek meaning rough eye. It is an extremely contagious eye disease that can lead to blindness. The cause of trachoma is a bacterial infection from the Chlamydia trachomatis and it is spread by direct contact. Secretions from the nose, eye and throat of infected individuals or contact with shared objects such as towels, washcloths is how the disease is spread. The bacteria can be in the body for up to 12 days before symptoms similar to pick eye appear.

Trachoma
Trachoma


This disease is one of the earliest eye diseases recorded in history, documented in 27 BC. People affected with trachoma are primarily living in third world, poverty stricken countries in Africa, the Middle East and Asia. This disease has been eliminated from the United States, with the last individuals afflicted from the American Indian population and people of Appalachia. Trachoma is the leading cause of blindness due to infection. It is also preventable.

The Helen Keller Institute based in New York City has implemented the World Health Organizations (WHO) education strategy called SAFE, for Surgery, Antibiotics, Face cleanliness and Environment improvements). This is a cutting-edge community based movement that is implemented via school programs, women’s literary training and health worker training in trichiasis surgery (repairing of the eyelids).

The disease is present in 55 countries and has caused blindness in six million individuals and over 150 million people infected. Surgery to repair eyelids costs as little as ten dollars. Women and children are three times more likely to get trachoma than men. Seventy-five percent of the infected population are in Africa.

Symptoms

Trachoma presents with symptoms similar to pink eye or conjunctivitis. Other symptoms are eye discharge, swollen eyelids, trichiasis (which is turned in eyelids), swollen lymph nodes (in front of the ears) and corneal scaring.

Diagnosis

This disease is diagnosed by culturing the organism or antigen from a scraping of the conjunctiva or isolating the bacteria in a culture.

Treatment

This disease is treated with oral antibiotics such as Zithromax. Oral antibiotics are used as a systemic approach so that long term complications such as blindness can be avoided. Other antibiotics used are erythromycin, derivatives of erythromycin and doxycycline. In severe cases eyelid surgery to correct the turned in eyelids is needed to prevent the chronic scaring of the cornea or lens. Eyelids that are not surgically repaired will cause blindness, due to the constant scraping of the eyelashes against the cornea.

A key to treatment is to prevent re-infection of the bacteria. Since trachoma is spread by direct contact from the secretions of an affected person or contact with shared objects that have touched the secretions, cleanliness is vital. Better sanitation, frequent hand washing, face washing and not sharing common cloths or towels are primary measures to avoid the spreading of the bacteria.

The prognosis of trachoma is dependent on early treatment. The earlier the infection is cured, the less likely is the chance of complications developing.

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