Summary
Definition
History and exam
Key diagnostic factors
- residence in or emigration from an endemic area
- at-risk demographic
- subtarsal conjunctival inflammation
- subtarsal follicles
- subtarsal conjunctival scarring
- trichiasis
- corneal opacification and visual loss
- Herbert pits
Other diagnostic factors
- asymptomatic
- ocular and nasal discharge
- red eye
- painful watery eye
- limbal follicles
- pannus
Risk factors
- children (ages 1 to 9 years)
- poor facial hygiene
- female sex
- poverty
- poor community hygiene
- crowded households
- residence in or emigration from an endemic area
- eye-seeking flies
Diagnostic tests
1st tests to order
- clinical diagnosis
Tests to consider
- polymerase chain reaction (conjunctival swab)
Emerging tests
- novel molecular and serologic tests
Treatment algorithm
resource-poor endemic area: based on prevalence of active trachoma
resource-rich nonendemic area: infected individual and family contact
resource-poor endemic area: trachomatous trichiasis
resource-rich nonendemic area: trachomatous trichiasis
Contributors
Authors
Van Charles Lansingh, MD, PhD, MBA
Associate Professor of Ophthalmology
Moran Eye Center
University of Utah
UT
Voluntary Associate Professor
Public Health Sciences
Miller School of Medicine
University of Miami
FL
Help Me See Chief Medical Officer
Director of Research
IMO (Mexican Institute of Ophthalmology)
Santiago de Queretaro
Mexico
Disclosures
VCL declares that he has no competing interests.
Kelly Callahan, MPH
Director
Trachoma Control Program
The Carter Center
Atlanta
GA
Disclosures
KC declares that she has no competing interests.
Acknowledgements
Dr Van Charles Lansingh and Ms Kelly Callahan wish to gratefully acknowledge Dr Paul Emerson, Dr Heathcote R. Wright and Dr Hugh R. Taylor, previous contributors to this topic.
Disclosures
PE declares no competing interests. HRW and HRT are authors of a number of references cited in the topic.
Peer reviewers
Matthew Burton, BChir
Lecturer
International Centre for Eye Health
London School of Hygiene and Tropical Medicine
London
UK
Disclosures
MB declares that he has no competing interests.
Victor Perez, MD
Assistant Professor
Miller School of Medicine
Bascom Palmer Eye Institute
University of Miami
Miami
FL
Disclosures
VP declares that he has no competing interests.
References
Key articles
World Health Organization. Trachoma control: a guide for programme managers. Jul 2006 [internet publication].Full text
World Health Organization. Report of the 4th global scientific meeting on trachoma, Geneva, 27-29 November 2018. Jun 2019. [internet publication].Full text
Evans JR, Solomon AW, Kumar R, et al. Antibiotics for trachoma. Cochrane Database Syst Rev. 2019 Sep 26;9:CD001860.Full text Abstract
Ejere HO, Alhassan MB, Rabiu M. Face washing promotion for preventing active trachoma. Cochrane Database Syst Rev. 2015 Feb 20;(2):CD003659.Full text Abstract
Burton M, Habtamu E, Ho D, et al. Interventions for trachoma trichiasis. Cochrane Database Syst Rev. 2015 Nov 13;(11):CD004008.Full text Abstract
Reference articles
A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
Differentials
- Chlamydial inclusion conjunctivitis
- Viral conjunctivitis
- Bacterial conjunctivitis
More DifferentialsGuidelines
- Trachoma control: a guide for programme managers
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