Trachoma

Trachoma
Other names	Granular conjunctivitis, blinding trachoma, Egyptian ophthalmia[1]
Surgical repair of in-turned eyelid and eyelashes resulting from trachoma
Specialty	Infectious disease
Symptoms	Eye pain, blindness[2]
Causes	Chlamydia trachomatis spread between people[2]
Risk factors	Crowded living conditions, not enough clean water and toilets[2]
Prevention	Mass treatment, improved sanitation[3]
Treatment	Medications, surgery[2]
Medication	Azithromycin, tetracycline[3]
Frequency	80 million[4]

Trachoma is an infectious disease caused by bacterium Chlamydia trachomatis.^[2] The infection causes a roughening of the inner surface of the eyelids.^[2] This roughening can lead to pain in the eyes, breakdown of the outer surface or cornea of the eyes, and eventual blindness.^[2] Untreated, repeated trachoma infections can result in a form of permanent blindness when the eyelids turn inward.^[2]

The bacteria that cause the disease can be spread by both direct and indirect contact with an affected person's eyes or nose.^[2] Indirect contact includes through clothing or flies that have come into contact with an affected person's eyes or nose.^[2] Children spread the disease more often than adults.^[2] Poor sanitation, crowded living conditions, and not enough clean water and toilets also increase spread.^[2]

Efforts to prevent the disease include improving access to clean water and treatment with antibiotics to decrease the number of people infected with the bacterium.^[2] This may include treating, all at once, whole groups of people in whom the disease is known to be common.^[3] Washing, by itself, is not enough to prevent disease, but may be useful with other measures.^[5] Treatment options include oral azithromycin and topical tetracycline.^[3] Azithromycin is preferred because it can be used as a single oral dose.^[6] After scarring of the eyelid has occurred, surgery may be required to correct the position of the eyelashes and prevent blindness.^[2]

Globally, about 80 million people have an active infection.^[4] In some areas, infections may be present in as many as 60–90% of children.^[2] Among adults, it more commonly affects women than men – likely due to their closer contact with children.^[2] The disease is the cause of decreased vision in 2.2 million people, of whom 1.2 million are completely blind.^[2] Trachoma is a public health problem in 42 countries across Africa, Asia, the Middle East, and Central and South America.^[7] There are 136.9 million people at risk.^[2] It results in US$8 billion of economic losses a year.^[2] It belongs to a group of diseases known as neglected tropical diseases.^[4]