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USAID

USAID's NTD Program
USAID's NTD Program

Trachoma

Symptoms

Photo of an infected eye.  
   

Infection often begins during infancy or childhood and can become chronic. Though young children are particularly susceptible to infection, the disease progresses slowly in childhood and the more painful symptoms may not emerge until adulthood.4 However, if left untreated, the infection eventually causes the eyelid to turn inwards, which in turn causes the eyelashes to rub on the eyeball, and other alterations of the eye such as lacrimal function and corneal limbus harm the cornea, causing severe pain and corneal opacity.1 This ultimately leads to irreversible blindness, typically between 30 and 40 years of age.4

The principal signs and symptoms in the early stages of trachoma include1:

  • Mild itching and irritation of the eye
  • Discharge from the eye containing mucus or pus

As the disease progresses, later trachoma symptoms include:

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

WHO has identified a grading system with five stages of trachoma. The stages are2:

  • Inflammation — follicular (TF). The infection is just beginning. Five or more follicles — small bumps that contain lymphocytes, a type of white blood cell — are visible with magnification on the inner surface of the upper eyelid (conjunctiva).
  • Inflammation — intense (TI). In this stage, the eye is now highly infectious and becomes irritated, with a thickening or swelling of the upper eyelid.
  • Eyelid scarring (TS). Repeated infections lead to scarring of the inner eyelid; the scars often appear as white lines when examined with magnification. The eyelid may become distorted and may turn in (entropion).
  • Trichiasis (TT) or ingrown eyelashes. The scarred inner lining of the eyelid continues to deform, causing the lashes to turn in so that they rub on and scratch the transparent outer surface of the eye (cornea). Only about 1 percent of people with trachoma develop this painful condition. A person’s risk of trichiasis probably increases in relation to the total number, duration, and intensity of C. trachomatis infections during his or her lifetime. As a result, trichiasis tends to occur more commonly in women because they tend to spend more time than men do with children, who are most frequently infected. It also becomes more and more common with increasing age.
  • Corneal clouding (CO). The cornea becomes affected by an inflammation that is most commonly seen under the upper lid. Continual inflammation – compounded by scratching from the in-turned lashes – leads to clouding of the cornea. Secondary infection can lead to development of ulcers on the cornea and eventually partial or complete blindness.

Photos of various stages of infection in eyes.

Photos of eyes at various stages of infection.

 

 

Learn more about Trachoma:



References

  1. . Burton, M.J. Trachoma: An overview. British Medical Bulletin. 84: 99-116, 2007.
  2. Thylefors, B., Negrel, AD., Pararajasegaram, R. et al. Global data on blindness. Bulletin of the World Health Organization, World Health Organization, Geneva, Switzerland. 73: 115-121, 1995.
  3. Berhane, Y., Worku, A., Bejiga, A. National Survey on Blindness, Low Vision and Trachoma in Ethiopia. Federal Ministry of Health of Ethiopia, 2006.
  4. Solomon, A.W., Holland, M.J., Burton, M.J., et al. Strategies for control of trachoma: Observational study with quantitative PCR. Lancet. 362: 198-204, 2003.