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)
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)
Risk factors
- children (active infection)
- poor facial hygiene
- female sex
- poverty
- poor community hygiene
- residence in or emigration from an endemic area
Diagnostic investigations
1st investigations to order
- clinical diagnosis
Investigations to consider
- polymerase chain reaction (conjunctival swab)
Emerging tests
- point-of-care conjunctival swab dipstick test
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
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.
Differentials
- Chlamydial inclusion conjunctivitis
- Viral conjunctivitis
- Bacterial conjunctivitis
More DifferentialsGuidelines
- Trachoma control: a guide for programme managers
- Primary health care level management of trachoma
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