Trachoma: Symptoms, Causes, Treatment, Cost, and Side Effects

Trachoma is a bacterial eye infection caused by chlamydia trachomatis. Trachoma can spread through direct or indirect contact with an infected person's eyes, eyelids, or secretions from their nose or throat. Handling contaminated objects, such handkerchiefs, can potentially spread it.Chlamydia infections are most frequent in the genital region, although they can also happen in uncommon locations such the anus, throat, and eyes. Direct or indirect contact with the bacteria might cause it to develop in the eyes. For instance, touching your eye without first washing your hands can spread the infection from the genitalia to the eye.

Chlamydia trachomatis often affects both eyes and might initially make your eyes and eyelids mildly itchy and irritated. After that, you might see puffy eyelids and pus coming out of the eyes. Children who experience repeated infections develop scar tissue, which results in the inversion of their eyelids and eyelashes in their adulthood, and if left untreated, trachoma can cause permanent blindness. Wherever, early treatment can treat the condition. The variant of chlamydia trachomatis bacterium that is responsible for blindness is caused by types A, B, Ba, and C.

Trachoma signs and symptoms may include the following;

• Itching and discomfort in eyes and eyelids
• Mucus- or pus-containing eye discharge
• Eyelid swelling
• Sensitivity to light (photophobia)
• Painful, irritated eyes
• Loss of vision

• Follicular inflammation: In the early stage, when seen under a magnifying glass, the inner surface of your upper eyelid (conjunctiva) will reveal five or more follicles, which are tiny bumps containing lymphocytes (a kind of white blood cell).
• Intense inflammation: The infected eye is now highly contagious. Top eyelid may thicken or swell at this stage.
• Eyelid scarring: The inner eyelid is scarred as a result of recurrent infections. When magnified, the scars frequently look as white lines. Your eyelid may turn inward and become deformed (entropion).
• In-turned eyelashes (trichiasis): Your eyelid's damaged inner lining continues to distort, causing your lashes to curl inward and rub against the translucent outside of your eye (cornea).
• Corneal clouding (opacity): An inflammation that most frequently appears under your top lid affects the cornea. The cornea becomes clouded as a result of ongoing inflammation that is aggravated by scratching from the in-turned lashes.

Your upper lid exhibits all trachoma symptoms more severely than your lower lid. This infection that started in childhood can carry over into adulthood if no action is taken.

Trachoma infection is particularly common in young children. However, the illness advances gradually, and the more severe symptoms may not show up until adulthood.

Certain variants of Chlamydia trachomatis, a bacterium that is responsible for sexually transmitted diseases, chlamydia, can also cause trachoma.

Trachoma is contracted by coming into contact with an infected person's discharge from the nose or eyes. Transmission can occur via hands, clothes, towels, and insects. Eye-seeking flies are a source of transmission in underdeveloped nations.

Trachoma can be eradicated or controlled on a community level by ending the cycle of infection and recurrence. This could be achieved by teaching children proper hygiene (including thorough face washing and hand cleaning) and ensuring that family members don't share towels and face cloths are two simple yet highly effective ways to promote cleanliness. Also, trachoma can be contained by increasing access to clean water, enhancing sanitation, and minimizing crowding.

The SAFE method popularized by the WHO is essential for treating trachoma. Where the ('S') stands for the ‘surgery to correct advanced stages of the disease’ , ('A') for ‘antibiotics to treat active infection, using azithromycin’, ('F') for ‘facial cleanliness to reduce disease transmission’, and ('E') for ‘environmental improvement to increase access to clean water and improved sanitation’.

Here are some do’s and don'ts to prevent trachoma;

• Maintaining personal hygiene by cleaning face and hand to clean it of any traces of blood, mucus or food particles that may attract eye-seeking flies carrying the potential of transmitting the bacteria through direct or indirect means
• Proper waste management that limits the amount of human and animal feces, food scraps
• Dispose of feces/ human waste in a safe way
• Access to a latrine
• Keep your house clean and clear of things that may attracts flies
• Apart from cleanliness, hygiene and sanitation, antibiotics can also be of great help in managing trachoma as a single dose of antibiotic can treat the infection
• It is simple to contain the spread of the bacterium that causes trachoma through towels, bed sheets, clothing, and washcloths. To eliminate the microorganisms that cause trachoma, wash these with soap
• Control moisture that attract flies
• Public and community areas such as schools, clinics, and streets should be swept clean of animal waste and food scraps

• Do not share towels or cloths that may contribute in an infection if someone has trachoma
• Discourage open defecation as a community
• Do not share contaminated materials or things like sunglasses, towels, handkerchief, bedsheets, pillows, quilts etc.
• Avoid coming in contact with the infected person’s mucus, eyes or nose discharge etc.
• Do not litter or do anything that may attract eye-seeking flies

As trachoma can have visible symptoms, most of the time it is diagnosed by a physical examination. However, in some cases different approaches are undertaken for the diagnosis, which are;

Your healthcare provider may diagnose your trachoma infection simply by looking at your eye or may also do a swab test by taking the sample of your eye discharge. Sometimes children do not exhibit any symptom in such a case, a swab test is mostly performed.

Trachoma typically affects both eyes and might include signs and symptoms similar to conjunctivitis that start to appear after an incubation period of 6 to 12 days. The symptoms are also closely similar to pink eye and majorly include mild eye and eyelid itchiness, eye discharge with pus or mucus, and swelling of eyelid.

Here are some classic symptoms to self-diagnose trachoma at home;
With related to eye

• Eye discharge with pus
• Swelling of eyelids
• Eyelashes growing inward
• Intolerance to bright light

Other systemic symptoms

• Swelling of lymph nodes in front of the ears
• Complications related to ear, nose and throat
• Increased heart rate

By looking out for these symptoms you can tell if you have trachoma by yourself.

With regard to viruses and bacteria, including chlamydia, the plant alkaloid berberine found in goldenseal exhibits strong antibacterial activity. However, given the severity of the infection that may lead to permanent blindness home remedies are not a recommended plan of action. Though some home cures for chlamydia may provide temporary symptom relief, only a proper course of antibiotics can treat the infection. You can, however, manage and control the spread and transmission of the infection by following proper facial hygiene, washing hands, not sharing things and objects that may contain the bacteria. To avert unpleasant events brought on by chlamydia take expert’s help.

The infection may go away on its own or with antibiotic treatment alone in the early stages of trachoma, but it can easily come back and leave more scarring on the surface of the eye and eyeball.

In order to up your immunity against trachoma it's crucial to take care of your eye health by eating nourishing foods like carrots and pineapple that are healthy for your eyes while also keeping up with regular hygiene. However, it has been observed in several experiments that food you eat does not have any effect on the course of trachoma.

Like any other infection, trachoma can also spread fast or worsen due to sugar intake. It has been noted that chlamydia bacteria thrive on the body’s sugar, hence cutting down on sugar intake may help in managing the severity of the infection.

Antibiotics are effective in treating trachoma in its early state. But with passing time the condition could deteriorate and might require a surgical intervention to treat the condition. The infection could recur within a few weeks of starting treatment.

Trachoma treatment options depend on the stage of the disease.
Medications

Antibiotics courses alone may be sufficient to eradicate the infection in the early stages of trachoma. The WHO suggests using tetracycline eye ointment and oral azithromycin to treat trachoma. The efficiency of azithromycin eye drops has also been demonstrated.

When more than 10% of youngsters develop trachoma, the World Health Organization (WHO) guidelines suggest administering antibiotics to the entire population. This recommendation's main objectives are to treat trachoma sufferers and stop the disease from spreading on the community level.

Surgery

• Eyelid rotation surgery or bilamellar tarsal rotation
• Corneal transplantation
• Epilation surgery

Trachoma can be a serious illness if not treated on time and may turn the patient blind. To help manage the complications, consult the expert team of eye specialists and surgeons at Pristyn care.

Timely treatment is very crucial and has shown immediate benefit in eliminating trachoma and preserving people’s eye vision. Hence, an urgent medical help is suggested for the management and control of trachoma when symptoms start to occur.

At Pristyn care, we have a team of expert eye specialists and surgeons who can take care of your eye health by doing the best course of action to treat your trachoma.

Treatment with antibiotics alone may be sufficient to cure trachoma in its early stages. Your physician might advise oral azithromycin or tetracycline eye ointment (Zithromax) to treat the infection.

One of the main objectives of treatment for trachoma is to provide surgery to those who are immediately at risk of going blind from the condition and to stop the spread of the bacteria so that future generations do not develop the chronic, blinding phases of the disease.

Here are some surgical treatments for trachoma;

• Eyelid rotation surgery or bilamellar tarsal rotation: This is done to rotate your eyelashes away from your cornea and to slow the development of corneal scarring and to help stop additional vision loss.
• Corneal transplantation: It is done in case the cornea becomes sufficiently cloudy to significantly impair eyesight.
• Epilation surgery: In some circumstances, you may undergo an epilation surgery to remove your eyelashes. There may be a need to repeat this process.

Surgery can be necessary to treat trachoma in its advanced stages, including the severe abnormalities of the eyelids.

• Eyelid rotation surgery or bilamellar tarsal rotation: Your doctor makes an incision in your scarred lid and rotates your eyelashes away from your cornea during eyelid rotation surgery. The technique slows the development of corneal scarring and might help stop additional vision loss.
• Corneal transplantation: This may be an option if your cornea has become sufficiently cloudy to significantly impair eyesight.
• Epilation surgery: In some circumstances, you may undergo an epilation surgery to remove your eyelashes. There may be a need to repeat this process.

Trachoma can be easily, inexpensively, and cost-effectively eliminated, with a high rate of success.

Trachoma is one of the major causes for blindness or visual impairment in under-developed and developing countries around the world. In moderately endemic areas, at least three years of single-oral dose of azithromycin administration, as per the WHO recommendation.

Though WHO’s SAFE initiative is successful in managing the spread and transmission of trachoma, and its two recommended medicinal treatments are found to be effective against the infection, yet the recurrence rate of trachoma is unfortunately very high and likely even after surgery.

If the patient is on medicine for the treatment of trachoma, they should apply the ointment and take their oral medication on time

Patients must not rub or scratch their operated eye(s) because doing so could cause an infection and disrupt the surgical sutures and correction

Patients should be instructed to see their healthcare provider in case of;

• Bleeding following surgery, that may be visible through the patch or after it has been removed
• Infection-related symptoms include persistent swelling, redness, discomfort, fever, itching, and discharge on the surgically repaired eyelid
• A sharp pain or agony coupled with excessive tearing. The most common cause of discomfort is a suture fragment or a broken eyelash that was tucked into the tarsal conjunctiva at the time of surgery and would repeatedly brush the cornea and/or conjunctiva while blinking
• The possibility of lashes still reaching the cornea following surgery
• When the operated eyelid does not close properly, there is an unattractive irregularity in the eyelid's curve, or both
• Between one and six months following surgery, granuloma, a sessile fleshy growth on the tarsal conjunctiva, may develop
• Good hygiene practices such as washing hands with soap, and washing faces with water should be kept on practicing

The side effects of a trachoma treatment may include;

• Heighten probability of developing antimicrobial resistance
• Swelling of eyelid post surgery
• Bleeding from the surgical site
• Possibility of corneal scarring as the lashes still reach the cornea following surgery
• Pain or excessive tearing due to rubbing of a suture fragment or a broken eyelash that was tucked into the tarsal conjunctiva during the time of surgery
• Recurrence

Despite the risks and side effects, a trachoma treatment is a good choice for people with chlamydia eye infection. The chances of countering the risks and side effects can also be ignored or reduced if the treatment is done by an expert ophthalmologist or eye surgeon at Pristyn care.

Trachoma is an eye infection that is brought on by a bacterium called the Chlamydia trachomatis. Contact with infectious discharges from the eyes and nose can spread the infection, especially in young children who are prone to the virus. Flies that have come into touch with the eyes and nostrils of affected persons can also spread it.

A single episode of infection can be cleared by the body's immune system, but in endemic areas, the infection is commonly re-acquired. After years of recurrent infection and scarring of the cornea, it can result in blindness that is irreversible. This, however, could be managed in early stages by taking a complete course of recommended antibiotics or if the infection advances a surgery may be needed to save the eyesight.

The infection could be controlled by following WHO’s SAFE guideline that encourages people to undergo surgery to correct advanced stages of trachoma, take antibiotics to treat active infection, keep your face clean to reduce disease transmission and an environmental improvement that increases access to clean water and improved sanitation.