1. TRACHOMA

2. Trachoma (granular conjunctivitis) is the world’s leading cause of preventable blindness
BBC Documentary
MedicineNet.com (quote)

3. Trachoma is a contagious infection in the eye caused by chlamydia trachomatis which causes blindness after multiple reinfections.
BBC Documentary
MedicineNet.com (quote)

4. Causes Chlamydia trachomatis
Spread by direct contact with eye, nose and throat secretions from affected individuals of with fomites such as towels, washcloths etc
Flies can be a route
Untreated repeated trachoma infections result in entropion – eyelids turn inward casusing the eyelashes to scratch the cornea

5. Chlamydia trachomatis is spread through direct contact with an infected person.
The most common agents of transmission are hands, handkerchiefs, and towels.
WHO “Water Sanitation Health: Water-related Diseases”
(1st sentence)
WHO Prevention of Blindness and Visual Impairment

6. Flies also play a major role in the spread of the disease.
WHO Prevention and Blindness and Visual Impairment

7. Poor sanitation, dirty water, and lack of hygiene are causes of trachoma.
MedicineNet.com

8. Signs and symptoms Symptoms of conjuctivitis, pink eye
White lumps in the undersuface of the upper eyelid (follicles)
Non specific thickening with papillae
Irrtating and watery discharge
Purulent discharge
Scarring in the eyelid
Lashes rub on the eye – trichiasis
Linear scar over the lid – arlt’s line
Resolved follicles leave small gaps – herberts pits
Swollen eyelids
Sensitivity to bright lights

9. WHO classification
Trachomatous inflammation, follicular (TF)—Five or more follicles of >0.5 mm on the upper conjunctiva
Trachomatous inflammation, intense (TI)—hypertrophy and inflammatory thickening of the upper conjunctiva with the presence of follicles
Trachomatous scarring (TS)—Presence of scarring in conjunctiva.
Trachomatous trichiasis (TT)—At least one ingrown eyelash touching the globe.
Corneal opacity (CO)—Corneal opacity or blurring part of the pupil margin

10. WHO grading chart

11. Trachomatous inflammation-follicular
WHO grading chart

12. Trachomatous inflammation-follicular and intense
WHO grading chart

13. Trachomatous scarring

14. Trachomatous trichiasis

15. Management Surgery Tarsal rotation procedure – for trichiasis
SAFE MEASURES –
SURGERY
ANTIBIOTICS
FACIAL CLEANLINES
EVIRONMENTAL HYGIENE
Surgery
Tarsal rotation procedure – for trichiasis
This involves incision of the scarred lid and external rotation of the distal margin by using 3 sutures

17. Antibiotics
Azithromycin – single oral dose of 20mg/kg Or
Topical tetracycline – ointment twice a day for six weeks

18. Life style measures
Facial cleanliness – children's with grossly visible nasal discharge, ocular discharge or flies on their faces are atleast twice likely to have trachoma
Community based health education
Environmental change to increase access to clean water and improved sanitation