Trachoma is a very prevalent eye disease in the world. It is caused by a bacterial infection and is more common in regions where there is no basic sanitation.
It is a serious disease as it can lead patients to blindness. However, with the right treatment, it is possible to have a cure. In the following text, we explain how it is possible to prevent. Read on to find out more!
Trachoma, also known as granulomatous conjunctivitis , is a bacterial inflammation that affects the eye region, being caused by the bacterium Chlamydia trachomatis.
This is a bacterium transmitted from person to person, through direct contact with the eyes or mucous membranes of someone infected and also through the sharing of personal objects.
Because it is a disease that can have recurrences, it is considered a chronic inflammatory condition, so it requires periodic eye monitoring.
The prevention of the disease occurs through measures of hygiene and basic sanitation. The diagnosis and treatment are made by the ophthalmologist, who advises the patient on the use of oral antibiotics and, in some cases, on the use of ointments and eye drops.
Treatment and medical follow-up are essential to prevent the disease from returning or to avoid complications, considering that trachoma is one of the main causes of blindness in the world.
In the International Classification of Diseases, ICD-10, trachoma is found in code A71 and in the segments:
- A71.0 – Initial phase of trachoma;
- A71.1 – Active phase of trachoma;
- A71.9 – Trachoma, unspecified.
Trachoma is caused by an infection caused by the bacterium Chlamydia trachomatis , a microorganism most present in regions where access to drinking water and basic sanitation is poor.
It is a bacterium that is among the smallest known living beings, being able to survive only in other organisms.
This bacterium, as the name may recall, is also responsible for causing other diseases, such as chlamydia, a sexually transmitted disease.
There are several serotypes of this agent, serotypes A, B, Ba and C being the ones most associated with ocular inflammation.
Some people are more vulnerable to trachoma. Because it is a disease associated with the lack of basic sanitation, people who live in this precarious situation are more vulnerable to suffering from this disease.
Although it is a disease that can affect anyone, children are more affected. One of the reasons for being a risk group is the fact that they have a lower immunity and because they are in environments where the circulation of bacteria is greater, such as schools.
Trachoma is an infectious disease that occurs through active infection in humans, and is not a bacterium present in other host animals. Contagion can happen not only in the ocular region, but also in other mucous membranes, such as in the respiratory or gastrointestinal tract.
Children under the age of 10 are considered the most likely group to be a reservoir of the bacterium in regions where the disease is endemic.
The transmission of the disease happens directly, that is, through contact with the infected person. It can occur through the exchange of kisses on the cheeks, hugs or handshakes after the person has touched the infected eye.
It can also be transmitted by contaminated objects, such as pillowcases, handkerchiefs, towels, eye drops, makeup, etc.
It is also possible that some insects act as vectors of the bacterium, such as the house fly (Musca domestica) and the lick-eye (Hippelates sp).
The disease is contagious when lesions are present, more common at the beginning of the disease. It can also occur more easily when the patient has other associated bacterial infections.
Upon contact with the human organism, the bacterium remains in an incubation period, which is the time between the time the person was infected and the first signs and symptoms. In the case of trachoma, the incubation time varies from 5 to 12 days.
This inflammation, in many cases, does not cause symptoms. When it manifests, it is more prevalent in children, being a disease of chronic course and with frequent relapses, and there may be more serious sequelae.
The main symptoms that you may have, although nonspecific, are:
One of the symptoms of trachoma is photophobia, a symptom present in several eye problems. In these cases, the inflammation leaves the patient very sensitive to light, requiring the use of sunglasses to help reduce discomfort in the light of the sun or ambient light.
The infection caused by the bacteria leaves the patient with a very irritated eye. Therefore, itching can also be one of the signs.
Foreign body sensation and redness
In eye infections or inflammations, it is common for patients to feel that there is sand or dust inside the eyes. This symptom, added to the others, can make the eye redder.
Secretion and tearing
The patient usually produces a greater amount of tears in the face of this infection. Pus secretion can also occur, usually when there is another bacterial infection associated with trachoma.
In this condition, the patient has inflamed follicles in the conjunctiva region. Thus, patients appear to have very small nodules in the inner region of the eyelids, being one of the characteristic symptoms of trachoma.
It occurs in patients in more advanced stages of trachoma. It is a symptom that occurs as a consequence of abrasions and scars on the cornea. Corneal opacification is a serious situation, as it can lead to impaired vision and even blindness.
The evolution of this disease can be divided into 4 stages:
The first stage, when the disease is still starting, occurs shortly after the incubation period has ended. At that time, it can cause tearing, sensitivity to light, swelling in the eyelids and increased blood flow in the eye area.
After a period of 7 to 10 days, the disease is considered to be in stage 2. At that moment, follicles may appear in the lining of the eyelids. These follicles can grow and increase in number and size for 3 to 4 weeks.
At this stage of the disease, the follicles gradually shrink in size and instead of these signs, scars may appear. When trachoma is not treated, the cornea can also suffer injuries and even scarring.
This scarring that can occur in the cornea is very dangerous, as it can involve this entire region of the eye, reducing vision.
Under these conditions, the patient is even more vulnerable to secondary bacterial infections, which increases the risk of disease progression and more serious complications.
In stage 4 of trachoma, the patient may experience entropion, a condition in which the eyelid is deformed and slightly turned inwards.
It is common for this condition to happen accompanied by trichiasis, which is when the eyelashes are in inappropriate positions and end up getting close to or inside the eyes.
There may also be obstruction of the tear duct, which reduces tearing and causes even more discomfort in the eyes.
When trichiasis and entropion happen simultaneously, they cause a greater formation of abnormal blood vessels in the corneas (neovascularization) and healing.
The diagnosis of trachoma is made through a clinical examination performed by an ophthalmologist.
In addition to analyzing the symptoms, the doctor must also perform an external eye exam, using a device (binocular loupe) capable of enlarging the size of the eye region, so that it is possible to observe whether there are scars and follicles in the eyelids or changes in the position of the lashes, for example.
This evaluation is important to be able to differentiate trachoma from a common conjunctivitis, in which there are no variations in the eyelid.
It is important for the correct diagnosis to also know the place where the patient lives, as there are some housing conditions that increase the risk of the disease.
For the diagnosis, a laboratory exam is not always done. Usually, the doctor relies on the analysis of symptoms and other risk factors that the patient has been exposed to.
For the physical examination, only one piece of equipment called a binocular loupe is used, which allows external evaluation of the eyes.
However, some laboratory tests can be done, being more for confirmation of the circulating bacteria than for the diagnosis and individual treatment of the disease.
In such cases, what is standard is the performance of bacterial culture, a technique that isolates the bacteria so that it can multiply within a process of control and analysis of the species.
However, it is not a routine examination in public health system laboratories.
Yes , there is a cure . When trachoma is diagnosed and treated correctly, it can be cured, but it is necessary for the patient to undergo periodic follow-up with the ophthalmologist, as in some cases the disease recurs.
The treatment of trachoma is done by administering antibiotic drugs. In some cases, it may be necessary for the patient to undergo surgery.
Medicines are indicated to cure bacterial infection, so, consequently, it is also possible to reduce the transmission and circulation of the bacteria, reducing relapses of the disease.
Surgery is not exactly a treatment that cures trachoma, but it may be necessary to correct deformities in the eyelids or eyelashes (entropion and trichiasis) that occur as a result of the disease.
Trachoma is treated with the use of antibiotic drugs, remedies traditionally used to fight a bacterial infection suffered by the body. However, the use of ointments or eye drops may also be recommended.
According to the guidelines of the Ministry of Health, the treatment of trachoma should be done with the use of antibiotics that have the active ingredient Azithromycin , which is available free of charge by public health services.
Some antibiotic eye drops may also be needed, such as those containing 1.5% azithromycin . The use of 2 times a day for up to 3 days may be recommended.
Ointments and eye drops
Some patients with trachoma may need the use of ointments and eye drops for symptom relief.
One of the eye ointments that may be recommended by the doctor are those that have tetracycline . Generally, they should be used twice a day for up to six weeks.
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained on this site is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
The prognosis of trachoma varies according to diagnosis and treatment.
It is important to know, in these cases, the importance of maintaining a routine of consultations with the ophthalmologist even after the disease is cured, since reinfection by the same bacteria can lead to more serious complications, such as trichiasis and entropion.
When these complications are not treated, trachoma can cause blindness.
According to information from the Ministry of Health, it is estimated that trachoma is responsible for causing eye problems in 1.9 million people. Within that number, about 450 thousand lose their sight irreversibly.
In addition, about 190 million people live in endemic areas and are at risk of contracting trachoma.
When left untreated, this disease can cause more serious problems in the patient, such as the characteristic conditions of trachoma: entropion and trachomatous trichiasis.
Entropion is a condition in which the eyelid is folded into the eye. This way, the eyelashes are bothering the eyeball.
Due to the friction that happens between the eyelashes and the eyeball, the patient can suffer abrasions on the cornea, which can make it opaque and thus end up reducing vision. To correct this disease, surgery is necessary.
It is the condition in which the eyelashes are in an abnormal position, usually into the eyes or very close. It is common for patients with severe conditions to have associated trichiasis and entropion.
Trachoma, in some untreated cases, can progress to the appearance of some scars on the cornea, due to the recurrence of infections and other complications such as trichiasis and entropion.
In these cases, corneal involvement can lead to impaired vision and even blindness.
Measures to prevent trachoma include simple care and others not so much. Because it is a more prevalent disease in regions with poor basic sanitation conditions, patients are unable to fully control transmission risk factors.
Therefore, to prevent trachoma, there is also a need for improvements in the environment in which these people live and measures that can reduce the risk of contamination of bacteria related to poor sanitation.
As far as people are concerned, there are the following preventive measures:
- Always wash your hands thoroughly with soap and water, several times throughout the day;
- Do not share personal objects that can transmit the bacteria;
- Go to the doctor when you notice any eye symptoms or discomfort;
- Conduct periodic consultations to preserve eye health.
Trachoma is an inflammatory eye disease that can cause severe sequelae, leading to blindness in extreme cases. Therefore, it is important not to ignore the symptoms and always seek an ophthalmologist.
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