Egyptian ophthalmia

Alternative names
Granular conjunctivitis; Trachoma

Definition
Trachoma is an eye infection caused by Chlamydia trachomatis, which may result in chronic scarring and blindness if left untreated.

Causes, incidence, and risk factors

Trachoma is caused by infection with the bacteria Chlamydiatrachomatis. It has an incubation period of 5 to 12 days and begins slowly as conjunctivitis (irritation near the eye, “pink eye”), which if untreated may become chronic and lead to scarring.

If the eyelids are severely irritated, the eyelashes may turn in and rub against the cornea. This can cause eye ulcers, further scarring, visual loss, and even blindness.

Trachoma occurs worldwide - primarily in rural settings in developing countries. It frequently affects children, although the consequences of scarring may not be evident until later in life. While trachoma is rare in the United States, certain populations marked by poverty, crowded living conditions, and/or poor hygiene are at higher risk for this illness.

Trachoma is acquired via direct contact with eye or nose-throat secretions from affected individuals or by contact with inanimate objects that are contaminated with these secretions, such as towels or clothes. In addition, certain flies that have fed on these secretions can transmit trachoma.

Symptoms

     
  • conjunctivitis  
  • discharge from the eye  
  • swollen eyelids  
  • turned-in eyelashes  
  • swelling of lymph nodes just in front of the ears  
  • cloudy cornea

Signs and tests

Trachoma is definitely diagnosed by detection of the organism or antigen in conjunctival scrapings or by isolation of the bacteria in culture.

Treatment
Systemic therapy with oral antibiotics can prevent long-term complications if used early in the infection. Active antibiotics include erythromycin and its derivatives, or doxycycline. In certain cases, eyelid surgery for lid deformities may be needed to prevent chronic scarring which can lead to blindness if not corrected.

Expectations (prognosis)
Early treatment before the development of scarring and lid deformities has an excellent prognosis.

Complications

     
  • scarring of the conjunctiva and cornea  
  • lid deformities  
  • turned-in eyelashes  
  • visual loss - if severe, may result in blindness

Calling your health care provider
Call your health care provider if you or your child recently visited an area of the world where trachoma is common and there are symptoms of conjunctivitis.

Prevention

Trachoma is spread by direct contact with eye, nose, and throat secretions from affected individuals or by contact with objects that may have been in contact with these secretions.

Improved sanitation and not sharing toilet articles such as towels are important measures for limiting the spread/acquisition of trachoma.

Johns Hopkins patient information

Last revised: December 5, 2012
by Potos A. Aagen, M.D.

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