Trachoma

 What it is?

Trachoma is an infectious eye disease caused by a type of bacteria called chlamydia trachomatis. It is the leading infectious cause of blindness. There are several types of this bacteria causing different diseases. Trachoma is caused by types A B and C other types cause other diseases such as chlamydia and lymphoma Aloma venereum. 

Causes

• The bacteria are spread from person to person through the eye nose and throat secretions of people who are infected. 
• It can spread directly from person to person or through an intermediary such as towels or washcloths contaminated with secretions, flies can also play a role in spreading the infection. 
• Trachoma occurs more commonly in young children. 
• It is also more common in women because of their greater contact with children. 

Let's have a look at how bacteria cause disease. 

• These bacteria infect the conjunctiva. 
• The conjunctiva is the lining that covers and protects the front of the eye and the inside of the eyelids. 
• This leads to inflammation of the conjunctiva also called conjunctivitis.
• Repeated infections can cause more and more inflammation of the conjunctiva which can eventually lead to scarring this usually happens over many years. 

Scarring of the conjunctival lining of the eyelid can cause it to be drawn inwards. This is called entropion, this results in the eyelashes rubbing against the eye a condition called trichiasis. Trichiasis can cause a lot of irritation discomfort and pain. It can also increase the risk of infection by other bacteria or viruses. Now if this keeps happening it can damage the cornea the front part of the eye and can eventually lead to irreversible blindness.

The diagnosis of trachoma is usually made by examining the eye. Sometimes eye swabs are taken to look for the presence of the bacteria. The severity of trachoma can be graded using a scale developed by the World Health Organization from mild to severe treatment depending on the severity of infection. There are effective antibiotics that can eliminate the bacteria and prevent the progression of the disease. 

Surgery can be used to correct the deformity of the eyelid and prevent further damage. The recovery of visual impairments will depend on how severe the damage to the eye is. Trachoma is a public health problem in about 42 countries around the world affecting communities that are poor and disadvantaged. It tends to occur in areas that are dry have crowded living conditions areas of water scarcity and poor sanitation. It is estimated that over 21 million people around the world have trachoma. About 1.9 million people have visual impairments or blindness due to the disease. Trachoma is a preventable disease with a devastating impact on individuals due to its effect on vision. It also affects families who have to care for those with the disease and has economic impacts due to the loss of productivity. 

So how is trachoma prevented?

The World Health Organization's safe strategy has been used in trachoma prevention programs worldwide it has 4 components. Surgery is used to correct eyelid deformities and prevent further damage to the eye. Antibiotics are used to treat the infection. The mass administration of antibiotics to entire communities has been a successful approach to clear the infection in communities with a high prevalence of trachoma promoting spacial cleanliness can reduce infectious secretions around the face and can also reduce flies being attracted to the face. This is used with other hygiene practices such as hand washing. Environmental changes that can be used to reduce transmission include activities such as improving sanitation by providing toilets improving access to clean water and controlling flies although researchers are trying to develop an effective vaccine against trachoma there is none currently available.