Trachoma

Last reviewed: 28 Oct 2022
Last updated: 31 Dec 2019

Summary

Definition

History and exam

Key diagnostic factors

  • residence in or emigration from an endemic area
  • at-risk demographic
  • subtarsal (beneath the eyelid) conjunctival inflammation
  • subtarsal follicles
  • subtarsal conjunctival scarring
  • trichiasis (the contact of 1 or more lashes on any part of the globe)
  • corneal opacification and visual loss
  • Herbert pits (small pits around the margin of the cornea)
More key diagnostic factors

Other diagnostic factors

  • asymptomatic
  • ocular and nasal discharge
  • red eye
  • painful watery eye
  • limbal (at the border of the cornea and sclera) follicles
  • pannus (vessels growing over the clear cornea)
Other diagnostic factors

Risk factors

  • children (active infection)
  • poor facial hygiene
  • female sex
  • poverty
  • poor community hygiene
  • residence in or emigration from an endemic area
More risk factors

Diagnostic investigations

1st investigations to order

  • clinical diagnosis
More 1st investigations to order

Investigations to consider

  • polymerase chain reaction (conjunctival swab)
More investigations to consider

Emerging tests

  • point-of-care conjunctival swab dipstick test

Treatment algorithm

ACUTE

resource-poor endemic area: based on prevalence of active trachoma

resource-rich nonendemic area: infected individual and family contact

ONGOING

resource-poor endemic area: trachomatous trichiasis

resource-rich nonendemic area: trachomatous trichiasis

Contributors

Authors

Van Charles Lansingh, MD, PhD

Help Me See Chief Medical Officer

Director of International Relations

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.

Paul Emerson, PhD, MSc

Director

International Trachoma Initiative

Decatur

GA

Disclosures

PE declares that he has no competing interests.

Acknowledgements

Dr Van Charles Lansingh, Ms Kelly Callahan, and Dr Paul Emerson wish to gratefully acknowledge Dr Heathcote R. Wright and Dr Hugh R. Taylor, previous contributors to this topic. 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.

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