Trachoma

Trachoma is a bacterial infection that affects your eye. Exposure to the bacterium Chlamydia trachomatis causes it. Repeated infections may damage your vision or lead to blindness.

Trachoma (pronounced “truh-KOH-muh”) is the leading cause of infectious preventable blindness worldwide. The disease is rare in the U.S. and Europe. But you may get the infection if you live or visit certain parts of:

• Africa
• Asia
• Australia
• Central and South America
• Middle East

Trachoma typically affects people who live in areas with limited access to clean water and sanitation.

Symptoms of trachoma

Trachoma symptoms vary. For example, a single incidence of trachoma may cause symptoms similar to conjunctivitis, such as itchy eyes and thick discharge from your eyes. Repeated infections may cause different symptoms, including:

• Blurred vision
• Sensitivity to light
• Severe eye pain
• Swollen eyelids
• Eyelashes or eyelids that turn in toward your eyeball

Eventually, some people who have repeated infections have vision loss or become blind.

Trachoma stages or grades

Healthcare providers may use grades or stages to classify trachoma. The World Health Organization (WHO) lists the following classifications:

• Trachomatous inflammation – follicular (TF): An eye exam shows you have five or more small bumps (follicles) on the inner surface of your upper eyelid.
• Trachomatous inflammation – intense (TI): Your upper eyelids are swollen, and your eyes are very itchy and irritated.
• Trachomatous scarring (TS): The insides of your upper eyelids show signs of scarring. Your eyelid may turn in toward your eyeball.
• Trachomatous trichiasis: Your eyelid may turn in toward your eyeball. An eyelash may turn in so it rubs against your cornea.
• Corneal opacity: Inflammation and damage from your eyelashes scratching your cornea causes it to become cloudy, so it’s hard for you to see.

Trachoma causes

Trachoma happens when you’re infected with the bacterium Chlamydia trachomatis. That can happen if you:

• Shake hands with or touch the face of someone who has the disease
• Touch infected bedding, clothing or even hard surfaces
• Spend a lot of time around flies while you’re in a part of the world where many people have trachoma

Flies can pick up the bacterium if they land in discharge from someone’s eyes or nose.

How to lower your risk

Taking the following steps can reduce your risk if you live or visit an area where trachoma is common:

• Wash your hands often.
• Try to avoid touching or rubbing your eyes.
• Don’t share towels or bedding.
• If you can, limit the amount of time spent in areas where there are a lot of flies.

How doctors diagnose trachoma

An eye doctor will ask about your symptoms and your overall health. They’ll also ask if you spent time in areas where many people have trachoma. Then, they’ll do an eye exam. They may swab your eyes to get a sample of pus or fluid. A lab will check the sample to find out if Chlamydia trachomatis is the cause of your eye infection.

How is trachoma treated?

Your treatment depends on your situation. For example, if you’re diagnosed before the infection causes inflammation and scarring, your provider may give you the antibiotic azithromycin and an ointment made with tetracycline.

Treatment will be different if you have repeated infections. For example, your provider may recommend that you have a procedure, like cryoablation, to remove eyelashes that turn in and scratch your cornea. They may recommend that you have a cornea transplant if trachoma causes serious damage to your cornea.

When should I seek care?

Talk to a healthcare provider if you have symptoms like itchy, irritated eyes or if you live or visit an area where trachoma is common.

What can I expect if I have trachoma?

Antibiotics typically cure trachoma if it’s your first infection. But repeated infections will affect your vision and may lead to blindness.

Is trachoma a serious public health concern?

The WHO estimates that nearly 2 million people worldwide have blindness or vision issues due to trachoma. But communities across the world are making progress through the SAFE strategy. SAFE stands for:

• Surgery to repair corneal damage
• Antibiotics to treat infections
• Facial cleansing to stop the spread
• Environmental changes, like more access to clean water and sanitation services