Трахома: причины, симптомы и лечение заболевания глаз

Infectious disease that causes a roughening of the inner surface of the eyelids

The later structural changes of trachoma are referred to as "cicatricial trachoma". These include scarring under the eyelid (tarsal conjunctiva) that leads to distortion of the eyelid with buckling of the lid (tarsus) so the lashes rub against the eye (trichiasis). This can lead to corneal opacities and scarring and then to blindness. Linear scars present in the sulcus subtarsalis are called Arlt's lines (named after Carl Ferdinand von Arlt). In addition, blood vessels and scar tissue can invade the upper cornea (pannus). Resolved limbal follicles may leave small gaps in the pannus (Herbert's pits). Most commonly, children with active trachoma do not present with symptoms, as the low grade irritation and ocular discharge is just accepted as normal, but further symptoms may include:
Eye discharge
Swollen eyelids
Trichiasis (misaligned eyelashes)
Swelling of lymph nodes in front of the ears
Sensitivity to bright lights
Increased heart rate
Further ear, nose, and throat complications. The most important complication to look out for is a corneal ulcer, which is caused by intense rubbing of the affected eye, or trichiasis with a superimposed bacterial infection.

Although trachoma was eliminated from much of the developed world in the 20th century (Australia being a notable exception), this disease persists in many parts of the developing world, particularly in communities without adequate access to water and sanitation. It is grouped as a neglected tropical disease which is a target for preventive chemotherapy.

Environmental improvement: Modifications in water use, fly control, latrine use, health education, and proximity to domesticated animals have all been proposed to reduce transmission of C. trachomatis. These changes pose numerous challenges for implementation. These environmental changes are likely to ultimately affect the transmission of ocular infection by means of lack of facial cleanliness. Health education also resulted in reductions of active trachoma when implemented. At lower prevalences, antibiotic treatment should be family based.

Azithromycin (single oral dose of 20 mg/kg) or topical tetracycline (1% eye ointment twice a day for six weeks). Azithromycin is preferred because it is used as a single oral dose. Although it is expensive, it is generally used as part of the international donation program organized by Pfizer. Evidence suggests that use of a lid clamp and absorbable sutures would result in reduced lid contour abnormalities and granuloma formulation after surgery. Early intervention is beneficial as the rate of recurrence is higher in more advanced disease.

The term is derived from Neo Latin trāchōma, from Greek τράχωμα trākhōma, from τραχύς trākhus "rough".

The economic burden of trachoma is huge, particularly with regard to covering treatment costs and productivity losses as a result of increased visual impairment, and in some cases, permanent blindness. The global estimated cost of trachoma is reported between $US2.9 and 5.3 billion each year. By including the cost for trichiasis treatment, the estimated overall cost for the disease increases to about $US 8 billion.