OPHTHALMIC EDUCATION TRACHOMA – Part 2 [Archives:2001/09/Health]

February 26 2001

Dr. Tawfik K. AL-Khatib
Ass. Prof. of ophthalmology
Faculty of Medicine
Sana’a University
The diagnosis of trachoma:
The characteristic signs of active trachoma are conjunctival follicles and papillae especially on the upper tarsal conjunctiva. Inactive trachoma can be diagnosed by: –
1.Lid changes;
2.Scarring of the upper tarsal conjunctiva;
3.Blood vessels on the upper part of the cornea;
4.Herbert’s pits at the limbos.
The treatment of Trachoma:
The trachoma organism is sensitive to certain antibiotics in particular Tetracycline, the Sulfonamide and Erythromycin.
Changes of the upper lids, namely trichiasis (extra eye lashes) and entropion (misdirection of the lids) are by far the most common and important complications of trachoma and can be treated surgically.
The prevention of trachoma:
To prevent blinding trachoma the following factors should be followed:
1-Improving personal and public hygiene is obviously the best way to eradicate blinding trachoma. This can be ensured by:
–Supplying pipe water, to encourage personal hygiene and the cleaning of clothes.
–Removing rubbish to control the fly population.
–Teaching personal hygiene to primary school children and young mothers.
2-Antibiotics can be effective in three different ways: –
–By destroying the organism in individual patients.
–Most of the seasonal conjunctivitis which aggravates trachoma responds to antibiotic treatment .
–If the whole community is treated, there are fewer active carriers to spread trachoma .
3-The surgical correction of lid problems( trichiasis and Entropion) is a valuable way to prevent blindness in the community.
4-Vaccination has been tried, but has not yet been successful.
Eye diseases in hot climates by John Sondford Smith, 2nd Edition.