Trachoma is a bacterial infection that affects the eyes. It is spread through direct contact with eyes, eyelids, and nose or throat secretions of infected people.

Trachoma is very contagious and almost always affects both eyes. Mild itching is the first sign and symptom of trachoma with irritation of the eyes and eyelids. Later this  leads to blurred vision and eye pain. Trachoma is the leading preventable cause of blindness worldwide. If trachoma is treated early, it often may prevent further trachoma complications. Otherwise, untreated trachoma can lead to blindness.

Symptoms

The basic symptoms in the early stages of trachoma include:

  • Mild itching and irritation of the eyes and eyelids.
  • Discharge from the eyes containing mucus or pus.

As the disease progresses, trachoma symptoms include:

  • Eye pain
  • Marked light sensitivity (photophobia)
  • Blurred vision

The World Health Organization has identified a grading system with five stages in the development of trachoma, including:

  • Inflammation – follicular.
  • Inflammation – intense.
  • Eyelid scarring.
  • Ingrown eyelashes (trichiasis).
  • Corneal clouding.

All the signs of trachoma are more severe in the upper lid than in the lower lid. With advanced scarring, the upper lid may show a thick line. In addition, the lubricating glandular tissue in the lids,  including the tear-producing glands (lacrimal glands) can be affected. This can lead to extreme dryness, aggravating the problem even more.

Causes

Trachoma is caused by certain subtypes of Chlamydia trachomatis, a bacterium that can also cause the sexually transmitted infection chlamydia.

Trachoma spreads through contact with discharge from the eyes or nose of an infected person. Hands, clothing, towels and insects can all be routes for transmission. In the world's developing countries, flies are a major means of transmission.

Risk Factors

Factors that increase the risk of contracting trachoma include:

  • Poverty.
  • Crowded living conditions.
  • Poor sanitation.
  • Age. In areas where the disease is active, it's most common in children ages 4 to 6.
  • Sex. Women contract the disease at rates two to six times higher than those for men.
  • Poor access to water.
  • Flies.
  • Lack of latrines or common toilets.

Complications

One occurrence of trachoma caused by Chlamydia trachomatis is easily treated with early detection and use of antibiotics. However, repeated infection can lead to complications, including:

  • Scarring of the inner eyelid
  • Eyelid deformities
  • Inward folding of the eyelid (entropion)
  • Ingrown eyelashes
  • Corneal scarring or cloudiness
  • Partial or complete vision loss

Prevention

If you are traveling to parts of the world where trachoma is common, be sure to practice good hygiene to prevent infection.

Proper hygiene practices include:

  • Face washing and hand-washing.
  • Controlling flies.
  • Proper waste management.
  • Improved access to water.