OPHTHALMIC EDUCATION (25) TRACHOMA Ð Part 1 [Archives:2001/08/Health]

Dr. Tawfik K. AL-Khatib
Ass. Prof. of ophthalmology
Faculty of Medicine
Sana’a University
Trachoma is the most common cause of preventable blindness in the world, with some 5.6 million people blind and around 146 million cases of active disease in need of treatment. The word Trachoma comes from the Greek word for “rough,” which describes the surface appearance of the conjunctiva (the white part of the eye) in chronic trachoma.
The highest incidence of trachoma is in the dry, hot, dusty, climatic zones which stretch from North India through the Middle East to North Africa and the Sahel region of central West Africa.
In Yemen it is common in western and southern areas such as Mareb, Hadramout and Shabwah.
The organism that causes trachoma is called Chlamydia Trachomatis, which has characteristics halfway between a bacteria and a virus.
The symptoms and signs of trachoma:
The symptoms are typical of any conjunctivitis:
1.Irritation of the eye;
2.Red eye;
3.Discharge;
4.Eyelid swelling;
5.Pain;
6.Light sensitivity and
7.Conjunctival and corneal changes like follicles and papillae.
The epidemiology of trachoma
Trachoma can vary from a mild to a very severe disease in different situations, the most severe form of trachoma is called hyperendemic trachoma and it is seen in some rural village communities, where almost every one has either active trachoma or scars from an earlier infection.
Why does the same infection produce a mild disease in one situation and a severe blinding disease in another situation?
Factors that influence the pattern of the disease are: –
1.Trachoma produces such poor and short-lived immunity that reinfection is very likely to occur.
2.Trachoma can only spread in poor, overcrowded communities with poor hygiene where conjunctival discharges frequently pass from eye to eye. This condition is sometimes called promiscuity, just as sexual promiscuity describes close genital contact in a community.
3.The main carriers of infection are children below the age of 10.
The disease spreads from child to child by: –
a) Direct contact from the fingers of children and their mothers;
b) Via cloths, handkerchiefs and pillows;
c) Overcrowding;
d) Poor hygiene and
e) In particular, large numbers of flies help the disease to spread.
Reference:
Eye diseases in hot climates by John Sondford Smith, 2nd Edition.

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