Trachoma

trachoma, chronic inflammatory disease of the eye caused by Chlamydia trachomatis, a bacterium-like microorganism that grows only within tissue cells of the infected host. Trachoma occurs especially under conditions of poverty, overpopulation, or poor sanitation and is often complicated by other eye infections of bacterial origin. Left untreated, it can result in irreversible blindness and is a leading cause of preventable blindness worldwide.

Transmission of C. trachomatis occurs by personal contact with infective ocular secretions or indirectly by common use of a towel. It may also be spread by flies that come into contact with eye or nose discharge from an infected person. Following infection with C. trachomatis, the conjunctiva becomes thickened and roughened, and deformation may result. Extension of inflammation to the cornea occurs in varying degrees; resultant scarring can lead to corneal opacity and blindness.

Antibiotics, particularly oral azithromycin and tetracycline eye ointment, are effective against trachoma. Surgery may be used to treat the later stages of disease, including trachomatous trichiasis, which is characterized by the turning in of the eyelashes to the degree that they touch the eye and scar the cornea. Scarring and clouding of the cornea may be treated by corneal transplantation. Trachoma can be prevented by routine handwashing and washing of the face, proper sanitation and waste disposal, control of fly populations, and access to clean water.

One of the oldest diseases known, trachoma is present in most areas of the world and is endemic in Asia, Australia, rural parts of Africa, Central and South America, and the Middle East. In the United States after about the mid-20th century, most cases were limited to a few localities. Beginning in 1957 with the discovery that the trachoma microorganism could be grown in the laboratory, fundamental studies on the disease agent, as well as development of experimental vaccines, became possible.