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Trachoma

Granular conjunctivitis; Egyptian ophthalmia; Conjunctivitis - granular; Conjunctivitis - chlamydia

 

Trachoma is an infection of the eye caused by bacteria called chlamydia.

Causes

 

Trachoma is caused by infection with the bacteria Chlamydia trachomatis.

The condition occurs around the world. It is most often seen in rural areas of developing countries. Children are often affected. However, the scarring caused by the infection may not be noticed until later in life. The condition is rare in the United States. However, it is more likely to occur in crowded or unclean living conditions.

Trachoma is spread through direct contact with infected eye, nose, or throat fluids. It can also be passed by contact with contaminated objects, such as towels or clothes. Certain flies can also spread the bacteria.

 

Symptoms

 

Symptoms begin 5 to 12 days after being exposed to the bacteria. The condition begins slowly. It first appears as inflammation of the tissue lining the eyelids (conjunctivitis, or "pink eye"). Untreated, this may lead to scarring.

Symptoms may include:

  • Cloudy cornea
  • Discharge from the eye
  • Swelling of lymph nodes just in front of the ears
  • Swollen eyelids
  • Turned-in eyelashes

 

Exams and Tests

 

The health care provider will do an eye exam to look for scarring on the inside of the upper eye lid, redness of the white part of the eyes, and new blood vessel growth into the cornea.

Lab tests are needed to identify the bacteria and make an accurate diagnosis.

 

Treatment

 

Antibiotics can prevent long-term complications if used early in the infection. In certain cases, eyelid surgery may be needed to prevent long-term scarring, which can lead to blindness if not corrected.

 

Outlook (Prognosis)

 

Outcomes are very good if treatment is started early before scarring and changes to the eyelids develop.

 

Possible Complications

 

If the eyelids become very irritated, the eyelashes may turn in and rub against the cornea. This can cause corneal ulcers, additional scars, vision loss, and possibly, blindness.

 

When to Contact a Medical Professional

 

Call your provider if you or your child recently visited an area where trachoma is common and you notice symptoms of conjunctivitis.

 

Prevention

 

Spread of the infection can be limited by washing your hands and face often, keeping clothes clean, and not sharing items such as towels.

 

 

References

Chidambaram JD, Chandler RD, Lietman TM. Pathogenesis and control of blinding trachoma. In: Duane TD, Tasman W, Jaeger EA, eds. Duane's Ophthalmology 2013. Philadelphia, PA: Lippincott Williams & Wilkins; 2013:vol 5, chap 60.

Hammerschlag MR. Chlamydia trachomatis. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 226.

Rubenstein JB, Tannan A. Conjunctivitis: infectious and noninfectious. In: Yanoff M, Duker JS, eds. Ophthalmology. 4th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 4.6.

 
  • Eye

    Eye - illustration

    The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle tunic layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

    Eye

    illustration

    • Eye

      Eye - illustration

      The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer or tunic (sclera, or white, and cornea) is fibrous and protective. The middle tunic layer (choroid, ciliary body and the iris) is vascular. The innermost layer (the retina) is nervous or sensory. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.

      Eye

      illustration

    Tests for Trachoma

     

       

      Review Date: 8/20/2016

      Reviewed By: Franklin W. Lusby, MD, ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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