Trachoma is an eye condition caused by a bacterium that can affect your eyesight if untreated. Trachoma is the leading infectious cause of blindness in the world.
Trachoma is an eye disease caused by a bacterium called Chlamydia trachomatis. The infection can cause irreversible blindness. It’s an issue in poor and rural areas throughout the world with poorer hygiene, limited access to clean water and sanitation, and problems with crowding.
In 2020, there were an estimated 32.8 million people in the world treated with antibiotics for trachoma, with over 42,000 people treated with surgery for the advanced form of the disease. About 1.9 million people are blind or visually impaired because of trachoma. Trachoma is responsible for about 1.4% of all cases of blindness throughout the world.
More than 40 countries classify trachoma as a public health issue, and Africa is the most affected continent. Other areas where trachoma exists include Asia, Australia, the Middle East and Central and South America.
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Signs and symptoms of early stages of trachoma include:
Advanced trachoma, or trachomatous trichiasis, happens after you have repeated infections and bouts of inflammation. The inflammation causes scar tissue on the inside of your eyelids and misdirection of your eyelashes, both of which scrape against your cornea. Your cornea is the clear and curved “window” on the front of your eyes that helps your eyes focus. After repeated episodes of trachoma, your cornea becomes opaque, which means light can’t get through.
Signs and symptoms of advanced trachoma include:
Trachoma is a bacterial infection that starts out being a little bit like pink eye (conjunctivitis), with symptoms of redness, irritation and discharge. Your provider can treat trachoma with an antibiotic in the early stages of the disease.
Trachoma spreads through personal contact, with infected discharge from eyes and noses touching other people’s hands or infected clothing or bedding. Flies can also spread the infectious discharge from one person to another. Symptoms can begin from five to 12 days after you’ve been exposed to the active infection.
Women and assigned female at birth and children are most often infected.
An eye doctor will take a medical history and ask you questions. They’ll want to know if you’ve been in areas where trachoma is present. Your provider will do an eye exam. In addition, they may take a sample of any fluid by numbing your eye and swabbing it. They can send this to a lab to find out if the source of infection is Chlamydia trachomatis.
In early stages, your provider can treat and cure trachoma by giving you antibiotics. The two drugs recommended for trachoma are azithromycin and an ointment made with tetracycline.
Trachoma that isn’t treated, or trachoma that happens repeatedly, can develop into trachomatous trichiasis. Your provider may suggest surgery. This can change the position of eyelashes so they no longer scrape your eye. This should prevent further scarring.
Severe damage to your cornea may lead your provider to recommend a corneal transplant.
If trachoma isn’t treated, you won’t be able to reverse the blindness that occurs.
Improving access to water supplies and sanitation services is key to stopping trachoma. Other strategies include improving crowded housing and getting rid of fly populations. Authorities throughout the world are making efforts to putting these actions into place to try to eliminate trachoma and trachoma blindness everywhere. The primary prevention strategy has an acronym — SAFE:
Some areas give children antibiotics at least once a year when they’re between 1 and 9 years old. This effort is known as blanket therapy, or blanket antibiotic therapy. There are some concerns about antibiotic resistance.
On a personal level, you can do some things to protect yourself if you live in an area where trachoma exists, or if you visit an area with trachoma. These include:
Your outlook is good if you have one episode of trachoma and take antibiotics. The complications start when you’ve had repeated episodes of the condition and your corneas are affected.
With surgery to correct the position of your eyelashes, further damage to your cornea will end.
But blindness caused by trachoma can’t be cured.
If you live or visit an area where trachoma exists and you have discharge from your eyes or nose, you should contact a healthcare provider. This is especially true if you have pain in your eyes. You should always contact a provider about pain in your eyes and other symptoms that concern you.
Chlamydial conjunctivitis is an eye disease caused by the sexually transmitted infection (STI), chlamydia. The bacterium is the same as the one that causes trachoma, but the subtypes of the germ are different. Trachoma isn’t an STI.
A note from Cleveland Clinic
If you live in or visit an area known to have trachoma — an eye condition caused by a bacterium infection — it’s important to take precautions to prevent transmission. You can help yourself by practicing vigorous hand washing and facial cleanliness. If your eyes get red or irritated, make sure you contact your healthcare provider. They can give you antibiotics to clear up symptoms and infections.
Last reviewed by a Cleveland Clinic medical professional on 07/23/2023.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy