trachoma

What is Trachoma?

Trachoma is a bacterial infection that affects the eyes, caused by the bacterium Chlamydia trachomatis. It's a serious eye disease that can lead to irreversible blindness if left untreated.

Causes and Transmission

• Trachoma is transmitted through direct contact with ocular and nasal secretions of infected persons [4].
• The infection can cause chronic keratoconjunctivitis, resulting from repeated infections with C. trachomatis [6].

Symptoms and Effects

• Trachoma affects both eyes and is the world's leading cause of infectious blindness [5].
• It causes a form of chronic conjunctivitis that can lead to the formation of scar tissue on the eye [8].
• If left untreated, trachoma can cause irreversible blindness, making it the leading preventable cause of blindness globally [7].

Key Facts

• Trachoma is caused by the bacterium Chlamydia trachomatis.
• It's transmitted through direct contact with infected persons.
• The infection can cause chronic keratoconjunctivitis and lead to irreversible blindness if left untreated.

References: [1] - Overview of Trachoma [2] - Trachoma: An Eye Disease Caused by a Bacterium [3] - Trachoma: A Disease of the Eye [4] - Transmission of Trachoma [5] - Trachoma: The World's Leading Cause of Infectious Blindness [6] - Chronic Keratoconjunctivitis and Trachoma [7] - Irreversible Blindness and Trachoma [8] - Definition of Trachoma

Trachoma Signs and Symptoms

Trachoma, an infectious disease caused by the bacterium Chlamydia trachomatis, can manifest in various ways. The signs and symptoms of trachoma are crucial for early detection and treatment.

• Eye Irritation: Redness and irritation of the eyes and eyelids are common symptoms of trachoma [1].
• Discharge from the Eyes: A watery or sticky discharge from the eyes is a characteristic sign of trachoma [2].
• Swollen Eyelids: Swelling of the upper eyelid, also known as conjunctival hyperemia, can occur in individuals with trachoma [6].
• Eye Pain and Light Sensitivity: Trachoma can cause eye pain, light sensitivity, and blurred vision [7].
• Conjunctivitis: Eye irritation, redness, and discharge (conjunctivitis) are symptoms of trachoma [5].

Additional Symptoms

In addition to the above signs and symptoms, trachoma can also manifest in children with clean faces. These symptoms include:

• Red, sore, sticky eyes
• Discharge from the nose

Transmission and Risk Factors

Trachoma is often associated with inadequate hygiene, crowded households, and limited access to water and sanitation [3]. These factors contribute to the spread of the disease.

Stages of Trachoma

The progression of trachoma can be divided into several stages, including:

• Stage 1: Trachomatous inflammation - follicular (TF)
• Stage 2: Trachomatous inflammation - intense (TI)

In stage 2, the eye becomes highly infectious and is characterized by a thickening or swelling of the upper eyelid [9].

References

[1] Jul 23, 2023 — What are the signs and symptoms of trachoma? [2] Nov 14, 2024 — Trachoma Symptoms [3] Oct 21, 2024 — Symptoms and transmission [5] May 8, 2023 — The symptoms include irritation of the eyes with tearing, pain, light sensitivity, and vision loss. [6] Oct 5, 2022 — Initial symptoms are conjunctival hyperemia, eyelid edema, photophobia, and lacrimation. [7] May 8, 2023 — The symptoms include irritation of the eyes with tearing, pain, light sensitivity, and vision loss. [9] A common sign that a person is suffering from trachoma is eyes that are moist with discharge such as mucus or pus.

Diagnostic Tests for Trachoma

Trachoma, an infectious disease caused by the bacterium Chlamydia trachomatis, can be diagnosed through various tests. Here are some of the diagnostic tests used to detect trachoma:

• Clinical Diagnosis: In most cases, trachoma is clinically diagnosed by examining the eyes for signs such as lymphoid follicles on the tarsal plate or scarring on the inside of the upper eyelid [8]. A healthcare provider will perform an eye exam to look for these symptoms.
• Laboratory Tests: Laboratory tests can be used to confirm the diagnosis. These tests include:
  • Polymerase Chain Reaction (PCR): This test detects the genetic material of the bacteria in a conjunctival swab sample [7].
  • Amplicor Test: Although officially indicated only for urogenital use, this test is commonly used in trachoma studies to detect the presence of Chlamydia trachomatis [3][6].
• Physical Examination: A healthcare provider can also diagnose trachoma through a physical examination by looking for signs such as redness of the white part of the eyes or scarring on the inside of the upper eyelid [9].

It's worth noting that testing is rarely available in endemic areas, and diagnosis is usually clinical [8]. However, laboratory tests can be used to confirm the diagnosis when available.

References: [1] Oct 21, 2020 — Your doctor can diagnose trachoma through a physical examination or by sending a sample of bacteria from your eyes to a laboratory for testing. [3] Although the Amplicor test (Roche Diagnostics) is officially indicated only for urogenital use, it is commonly used in trachoma studies. In the urogenital ... [6] Although the Amplicor test (Roche Diagnostics) is officially indicated only for urogenital use, it is commonly used in trachoma studies. ... In the urogenital ... [7] Jan 2, 2024 — Diagnostic tests. 1st tests to order. clinical diagnosis. Full details. Tests to consider. polymerase chain reaction (conjunctival swab). Full ... [8] Oct 5, 2022 — Diagnosis of trachoma is usually clinical because testing is rarely available in endemic areas. Lymphoid follicles on the tarsal plate or ... [9] Exams and Tests ... The health care provider will do an eye exam to look for scarring on the inside of the upper eye lid, redness of the white part of the eyes, ...

Treatment Options for Trachoma

Trachoma, an infectious disease caused by Chlamydia trachomatis, can be effectively treated with antibiotics. The primary goal of treatment is to eliminate the infection and prevent its progression to more severe stages.

• Azithromycin: This antibiotic is considered the first-line treatment for trachoma. A single dose of azithromycin has been shown to be highly effective in reducing the prevalence of active trachoma and ocular infection in communities [6][7]. The recommended dose for children is 20 mg/kg, while adults receive a standard dose [2].
• Tetracycline Eye Ointment: This antibiotic is also used to treat trachoma, particularly in cases where azithromycin is not available or contraindicated. It is applied topically to the affected eye(s) [1][3].
• Mass Drug Administration (MDA): In areas where trachoma is endemic, MDA with a single dose of oral azithromycin has been shown to be an effective strategy for reducing the prevalence of active trachoma and ocular infection in communities [6].

Additional Treatment Options

In more severe cases of trachoma, surgery may be necessary to treat trachomatous trichiasis (the blinding stage) [4]. Additionally, antibiotics such as doxycycline can be used to treat trachoma, although they are not typically the first-line treatment [8].

Recommendations

The World Health Organization (WHO) recommends annual mass administration of azithromycin and tetracycline eye ointment for trachoma control in endemic areas [3][9]. A single dose of an antibiotic (azithromycin) is also recommended as the standard treatment for all people with active trachoma [7].

References: [1] Oct 21, 2020 — Your doctor may prescribe tetracycline eye ointment or oral azithromycin (Zithromax). [2] Jan 18, 2023 — The dose for children is 20 mg/kg in a single dose; adults receive a standard dose. [3] Jan 18, 2023 — The WHO recommends 2 antibiotics for trachoma control: oral azithromycin and tetracycline eye ointment. [4] Oct 21, 2024 — Surgery to treat the blinding stage (trachomatous trichiasis); · Antibiotics to clear infection... [5] Jul 23, 2023 — The two drugs recommended for trachoma are azithromycin and an ointment made with tetracycline. [6] by JR Evans · 2019 · Cited by 136 — Mass antibiotic treatment with single dose oral azithromycin reduces the prevalence of active trachoma... [7] Treatment for trachoma. A single dose of an antibiotic (azithromycin) is the recommended treatment for all people with active trachoma. [8] Drugs used to treat Trachoma ; Generic name: doxycycline systemic; Brand names: Vibramycin, Doxy 100... [9] by AW Solomon · 2008 · Cited by 89 — Single-dose azithromycin is the first-choice antibiotic for the treatment of trachoma.

Differential Diagnosis of Trachoma

Trachoma, also known as granular conjunctivitis or Egyptian ophthalmia, is a bacterial infection of the eye caused by Chlamydia trachomatis. The differential diagnosis of trachoma includes several conditions that can present with similar symptoms.

• Allergic Conjunctivitis: This condition is characterized by an allergic reaction to environmental allergens, leading to inflammation and redness in the eyes. It can be a common cause of conjunctival irritation and should be considered in the differential diagnosis of trachoma.
• Viral Conjunctivitis (Adenovirus): Viral conjunctivitis is caused by an adenovirus infection and can present with symptoms similar to trachoma, including redness, swelling, and discharge from the eyes. It is essential to consider viral conjunctivitis in the differential diagnosis of trachoma, especially in cases where there is a history of recent viral infections.
• Bacterial Conjunctivitis (Moraxella): Bacterial conjunctivitis is caused by Moraxella bacteria and can present with symptoms similar to trachoma, including redness, swelling, and discharge from the eyes. It is essential to consider bacterial conjunctivitis in the differential diagnosis of trachoma.
• Adult Inclusion Conjunctivitis: This condition is caused by an infection with urogenital Chlamydia and can present with symptoms similar to trachoma, including redness, swelling, and discharge from the eyes. It is essential to consider adult inclusion conjunctivitis in the differential diagnosis of trachoma.

According to a study published in 2016 [9], the differential diagnosis of trachoma includes allergic conjunctivitis, viral conjunctivitis, bacterial conjunctivitis, and inclusion conjunctivitis. A clinical diagnosis based on high suspicion is often made for trachoma, with PCR testing developed for confirmation [8].

References: [1] - Trachoma, also known as granular conjunctivitis or Egyptian ophthalmia, is a bacterial infection of the eye caused by Chlamydia trachomatis. [2] - The differential diagnosis of follicular conjunctivitis includes adult inclusion conjunctivitis (caused by infection with urogenital Chlamydia). [3] - Trachoma is endemic and has several differential diagnoses including allergic conjunctivitis, viral conjunctivitis, bacterial conjunctivitis. [4] - The differential diagnosis of trachoma include: allergic conjunctivitis, viral conjunctivitis, bacterial conjunctivitis and inclusion conjunctivitis. [5] - Trachoma is a clinical diagnosis based on high suspicion based on the above mentioned clinical findings.