Trachoma: Signs and Symptoms, Diagnosis, Treatment

WHAT IS TRACHOMA?

WHAT IS TRACHOMA

Trachoma or Granular conjuctivitis or Egyptian opthalmia is a chronic keratoconjuctivitis or inflammation of cornea and conjunctiva caused by a bacterium Chlamydia trachomatis. This bacterium causes roughening of inner eye lid which causes pain in eye,breakdown of the outer surface or cornea and in severe conditions, often leads to blindness.




ETIOLOGY OF TRACHOMA

A. CAUSATIVE ORGANISM

Chlamydia produces inculsion bodies called as H.P. bodies (Halsberstaedter Prowazeke bodies). Till now, 11 serotypes of Chlamydia trachomatis is known (A, B, Ba, C, D, E, F, G, H, I, J & K). Serotype A, B, Ba and C are associated with hyper endemic trachoma, while serotype D-K are associated with paratrachoma.

Following is a complete list of infections caused by Chlamydia:-

                                           

B. PREDISPOSING FACTOR

  1. Age- infants and children are more susceptible
  2. Sex- Females>Males
  3. Race- more common in Jews & less common in Negroes
  4. Climate- dry and dusty places
  5. Socioeconomic status- poor people with unhygienic living conditions

C. SOURCE OF INFECTION

The main source of trachoma at endemic areas is conjunctival discharge of affected person. Thus, superimposed bacterial infection helps in transmission of trachoma.

D. MODES OF INFECTION

Infection may spread by any of the following modes:

SYMPTOMS OF TRACHOMA

  1. Symptoms are less if no secondary infection is there and mainly includes sensation of dust particle in eyes, sometimes leads to lacrimation, stickiness of eye lids and scanty mucoid discharge.
  2. If secondary infection is present, symptoms of acute mucopurulent conjuctivitis are seen.


SIGNS OF TRACHOMA

Signs of Trachoma are seen in conjunctiva as well as cornea:-

SIGNS SEEN IN CONJUCTIVA

sago grains follicles trachoma signs

SIGNS SEEN IN CORNEA

herbert's pits pitted cornea follicles trachoma signs
herbert's pits follicles pitted cornea trachoma signs



WHO CLASSIFICATION OF TRACHOMA

The WHO Grading System grades Trachoma into N (Normal tarsal conjunctiva), TF (Trachomatous inflammation- follicular), TI (Trachomatous inflammation- Intense), TS (Trachomatous Scarring), TT (Trachomatous Trichiasis) and lastly, CO (Corneal Opacity).

DIAGNOSIS OF TRACHOMA

Following tests are done for diagnosis of trachoma:-
  1. Conjuctival cytology
  2. Detection of inculsion bodies
  3. ELISA
  4. PCR
  5. Isolation of chlamydia
  6. Serotying of TRIC agents

MANAGEMENT OF TRACHOMA

Management of Trachoma follows Surgical, Medical and Personal management:-

A. SURGERY

Surgery is done to correct eyelid deformity which is known as trichiasis.

B. ANTIBIOTICS

Medcical treatment involve commonly used antibiotics:-
  1. Azythromycin is a first line drug used in trachoma.(250mg od x 4 days)
  2. Tetracyclin is second line drug,contraindicated in children under 8 years.taken as ointment of 1% concentration for 4 times a day for 6 weeks.
  3. Sulfacetamide is taken as eye drops of 20% concentration 3 times a day along with tetracycline for 6 weeks.

C. FACIAL CLEANLINESS


Facial cleanliness is an important approach in prevention of trachoma and is a vital component in stopping the trachoma transmission cycle.

D. ENVIRONMENTAL IMPROVEMENT 

Environmental change for better sanitation and increase the access to cleaner water and air this reduces the chances of contact with the infected medium or vectors.


More about this article: -

WHAT IS TRACHOMA
October 24, 2015
4.5/5 stars
Trachoma- Definition, signs and symptoms, diagnosis, treatment.

Labels: ,