Trachoma Eye Disease – Symptoms, Causes, and Treatment

An eye infection that affects both eyes, trachoma eye disease is the leading cause of preventable blindness worldwide. In fact, according to statistics collected by the World Health Organization (WHO), trachoma is responsible for the visual impairment of over 2 million people. And of those individuals, over 1 million are irreversibly blind. As it is a preventable and treatable condition, it is particularly important to be aware of early symptoms of the condition as well as suggested methods of treatment.

What Is Trachoma Eye Disease?

Trachoma is a bacterial infection that affects both eyes. It is an extremely contagious condition and is spread through contact with secretions of affected mucous membranes, including the eyes, eyelids, nose, and throat.

In its early stages, trachoma eye disease causes mild itching and irritation. However, it can progress rather quickly if left untreated and cause complications such as swollen eyelids and pus-like drainage from the eyes. If the condition progresses too far without treatment, it can lead to blindness.

Trachoma Progression Stages

The World Health Organization (WHO) has identified five stages in the progression of the disease:

1. Follicular Inflammation. This is the beginning stage of the infection. In this stage, five or more follicles, or small bumps that contain a specific type of white blood cell, can be identified with magnification on the upper lid of the eye (conjunctiva).
2. Intense Inflammation. In this stage, the eye is highly infectious and becomes extremely irritated. This stage is also when thickening and/or swelling of the upper eyelid begins to occur.
3. Eyelid Scarring. After repeated infections, scarring of the eye begins. When under magnification, the scars appear as white lines.
4. Ingrown Eyelashes. Also known as trichiasis, this stage occurs when scarring becomes severe enough to turn the eyelid inward, causing the lashes to rub and scratch the cornea, the clear outer covering of the eye.
5. Corneal Clouding. In this stage, the cornea becomes impacted by inflammation that typically forms under the upper eyelid. The constant inflammation in combination with the scratching from the in-turned lashes leads to advanced clouding of the cornea.

The agency also reports that an estimated 6 million people have been blinded by this preventable eye disease. Most of the cases resulting in blindness are located in destitute areas of Africa. In any case, however, early treatment is key to prevent complications of the disease.

Symptoms of Trachoma

In its earliest stages, trachoma causes the condition commonly known as pink eye or conjunctivitis. These symptoms typically begin to appear five to twelve days after exposure to the bacterium. These symptoms often include itching and irritation of the eyes. A yellow-like discharge that may form crusts at the lash line is also common. Additional symptoms that indicate the onset of the condition include:

• Mild itching in one or both eyes or eyelids;
• Mucus or pus discharged from the eyes;
• Swelling of the eyelid;
• Sensitivity to light or photophobia;
• Pain in the affected eye.

As the condition progresses, it causes increased pain and blurred vision. If trachoma is left untreated, scarring develops within the eyelid. This buildup of scar tissue causes the eyelashes to turn inward toward the eye. This condition is called trichiasis. Once the eyelids turn inward, the lashes brush against the cornea constantly. The irritation that results clouds the cornea and can cause corneal ulcers and irreversible vision loss.

It is important to note that one episode of trachoma eye disease will likely not cause vision problems. Rather, it is believed that repeated infections over time is what causes the advanced scarring of the eye and the complications that lead to blindness. In most cases, it takes years for the condition to lead to vision loss.

Causes of Trachoma

The condition is caused by specific subtypes of Chlamydia trachomatis, a bacteria that can also cause the sexually transmitted disease chlamydia. The bacteria is spread through contact with the infected discharge, such as from the eyes or nose of the affected individual.

Trachoma can also be spread by touching the infected hands, clothing, or towels of a person with the condition. In developing countries, the spread of the disease may also be a result of contact with flies or other insects that have come in contact with the nose or eyes of an infected person.

Who Is At Risk?

Children are most susceptible to the infection itself. However, the disease has a slow progression, and many of the more painful symptoms may not develop until adulthood.

At any rate, the condition is considered rare in the United States and Europe and is much more common in developing nations. This distribution is likely a result of the crowded living conditions and poor sanitation in poverty-stricken areas.

General risk factors for contracting trachoma eye disease include:

• Living conditions. Areas of poverty, such as those in developing countries, where living conditions are cramped and often unsanitary contribute to the spread of disease.
• Age. The disease is most common in children between the ages of 4 and 6.
• Sex. In many areas, females contract the disease anywhere from two to six times more frequently than men.
• Insect population. Areas with insect control problems have a higher rate of infection.

Treatment for Trachoma

Treatment of the disease generally depends on the stage. Early stages of trachoma can be effectively treated using medication, such as antibiotics. Many doctors prescribe tetracycline eye ointment or oral azithromycin to treat the condition.

In more advanced stages, when eyelid deformities are present, surgery may be required. Surgery may involve an eyelid rotation during which the doctor makes an incision in the scarred lid and rotates the lashes away from the corner. If the cornea has already become significantly clouded, however, a corneal transplant may be advised, but the results of this treatment with trachoma have not been promising.

Alternatively, some individuals have a procedure done to remove the eyelashes. This procedure may be performed repeated. Likewise, an additional option, if surgery is not available, is to bandage the eyelashes to keep them from touching the eye.

Preventing Eye Disease

Prevention of the infection is also an important component of treatment. Proper hygiene practices can go a long way toward prevention. These suggestions include:

• Regular face and hand washing;
• Improved control of fly and insect populations;
• Proper waste management;
• Increased access to water.

While there is no vaccine available for the condition, WHO has developed a strategy to prevent the condition with an aim at eliminating it by the year 2020. The strategy is titled SAFE and includes:

• Surgery to treat advanced cases of the condition;
• Antibiotics to prevent and treat the infection;
• Facial cleanliness;
• Environment improvements, specifically in water, sanitation, and insect control.

Summing Up

As the leading cause of preventable blindness, trachoma eye disease is a grave concern worldwide but specifically in developing conditions. Initial onset of the condition involves the relatively common condition pink eye; however, if it is left untreated, it can lead to serious complications. Treatment through antibiotics for the early stages of the condition and surgery for more advanced cases are available. But prevention is the real aim at treating and eliminating the condition.