Trachoma | The Fred Hollows Foundation NZ

Trachoma

Trachoma is most common in the poorer rural areas of Africa, Asia, Central and South America, Australia and the Middle East. In Australia, trachoma is almost exclusively found within the Indigenous population.

What is trachoma?

Eye nurse screening children for eye disease. Image: Kristian FriresTrachoma (meaning “rough eye”) is an infectious eye disease caused by a micro-organism called Chlamydia Trachomatis which causes inflammation of the lining tissue of the eye and eyelids (the conjunctiva).

The micro-organism spreads through contact with eye or nose discharge of an infected person, especially by flies, fingers, towels and handkerchiefs.

After years of repeated infection and inflammation, the conjunctiva becomes rough and scarred. The inflammation also affects its ability to lubricate, nourish, and protect the eye.

The cornea can also become inflamed which causes scarring, and hazy vision.

The inside of the eyelid can become so severely scarred that the eyelid turns inward and the lashes rub on the eyeball, further scarring the cornea (the front of the eye). This is both painful and damaging to the cornea.

If untreated, this can cause irreversible corneal scars and blindness.

Who gets trachoma?

Eyelids are flipped during screening for trachoma symptoms.Trachoma is a marker of poverty and low living standards, particularly overcrowding, poor sanitation and nutrition.
Children under the age of five predominantly tolerate the active infection but the pain, scarring and damage to the eye is often felt in adulthood.

Due to their role as primary carers of children, women are also often at higher risk of being affected by the condition.

What is the burden from trachoma?

Trachoma affects 84 million people globally.

Trachoma is most common in the poorer rural areas.

Can trachoma be treated?

In its early stages, trachoma is easily treated. Once corneal scarring has occurred in the advanced stages of the disease, treatment is more difficult and often unsuccessful.

SAFE strategy

In many instances, treatment and control of trachoma has been implemented using the S.A.F.E strategy:

S - surgery

A - antibiotic treatment

F - facial cleanliness

E - environmental improvement, which includes providing access to clean water to help reduce the activity and spread of the disease.

Can trachoma be prevented?

The above SAFE strategy aims both to treat and to prevent trachoma. The key to prevention is to help communities emerge from poverty and dispossession.

Trachoma always disappears from communities when they go from poverty to even a reasonable level of prosperity. This seems to be mainly due to the breaking of the intense cycle of infection and re-infection which occurs in impoverished communities.

When communities are still living in poverty, data about the disease needs to be gathered and used to plan which communities need to have treatment with antibiotics and who is to receive it.

Cases of scarring of the eyelids need to be identified so that early corrective surgery is done to help prevent scarring of the cornea.

If trachoma starts to die out in a community, people with damage from earlier infections still need to be monitored to prevent scarring the cornea.

Note: This information is general in nature and is not a substitute for specialist medical advice. Have your eyes checked regularly every two years, even if you have not noticed any symptoms or changes.

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