Active trachoma is a keratoconjunctivitis caused by infection with Chlamydia trachomatis (serovars A, B, Ba, and C), occurring predominantly in children.
Children who have had multiple or severe episodes of active trachoma may develop cicatricial disease in later life.
Trachomatous cicatricial disease is characterised by tarsal conjunctival scarring, predominantly of the upper lid. It may ensue over the subsequent decades and can lead to trachomatous trichiasis (the contact of 1 or more lashes on any part of the globe), corneal opacity, and subsequent loss of vision.
Antibiotics, in conjunction with facial cleanliness campaigns and environmental improvements targeted at communities at risk, aim to reduce the reservoir of infection within a population.
Poor facial cleanliness may be the most important modifiable risk factor in children who develop trachoma.
Prompt surgery must be provided to adults who have trichiasis in order to prevent blindness.
Trachoma is a keratoconjunctivitis caused by ocular infection with Chlamydia trachomatis (serovars A, B, Ba, and C). It should not be mistaken for chlamydial conjunctivitis, which is a self-limiting conjunctivitis caused by the sexually transmitted strains of Chlamydia (serotypes D to K). Inflammatory episodes in adults tend to be shorter and less severe than in children. Repeated infections lead to recurrent episodes of chronic inflammation that may progress to scarring of the upper tarsal conjunctiva. The scarring results in distortion of the upper eyelid, and this can cause lashes to abrade the cornea. This is called trachomatous trichiasis and, unless surgically corrected, will rapidly lead to corneal opacity and blindness.
Gerard Crock Fellow
Centre for Eye Research Australia
Director of Ophthalmology
Townsville Hospital and Health Service
HRW is an author of a number of references cited in this monograph.
Harold Mitchell Professor of Indigenous Eye Health
Melbourne School of Population and Global Health
University of Melbourne
HRT is an author of a number of references cited in this monograph.
International Centre for Eye Health
London School of Hygiene and Tropical Medicine
MB declares that he has no competing interests.
Miller School of Medicine
Bascom Palmer Eye Institute
University of Miami
VP declares that he has no competing interests.
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