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Trachoma : Causes, Symptoms, Treatment and Prevention

Trachoma is an infection that attacks the eye. According to data from the World Health Organization (WHO), infection due to the bacterium Chlamydia trachomatis has caused blindness in nearly 2 million people in the world.

This disease must be taken seriously. Otherwise, this eye infection can cause long-term complications, such as visual impairment and even permanent blindness.

Trachoma usually attacks the eyes and eyelids first, with initial symptoms of mild irritation and itching. But if left untreated, trachoma can cause serious complications to blindness. Keep in mind that blindness caused by trachoma is permanent and cannot be treated again.

Trachoma can infect children easily. However, this disease usually develops very slowly. Symptoms can occur when the patient has grown up.

Trachoma Transmission Process

Transmission is easy to occur through contact with the patient's body fluids. For example, through touching with eye fluids or the patient's nasal mucus splashes. Contaminated items can also transmit these bacteria.

If you touch the mucus on the body of a patient or item that has been contaminated with the bacteria, then hold your eyes, this bacteria can enter your body.

Trachoma Symptoms

Symptoms of trachoma generally occur in both eyes, including:




  • Itching and irritation of the eyes, including the eyelids.
  • Eye pain.
  • Feeling more sensitive to light (photophobia).
  • Eyelid swelling.
  • The discharge from the eyes containing pus and mucus.

To identify the severity of trachoma, WHO determined the existence of 5 stages of the development of this disease, namely:

  • Follicular inflammation. This stage is the initial stage of development of trachoma which is characterized by the appearance of follicles in the eye, which can be seen with the help of a magnifying glass. This follicle is shaped like a small lump containing white blood cells (lymphocytes), which are located on the inside of the upper eyelid.
  • Severe inflammation. This stage is characterized by eye irritation and severe infection, and is accompanied by swelling and thickening of the upper eyelid.
  • Injuries to the inner eyelids. Infection and irritation in the previous stages can cause injury to the eyelids. This wound can be seen with a magnifying glass that looks like white lines. At this stage, the eyelids can experience changes in shape (distortion) and bend to the inside (entropion).
  • Trichiasis occurs when the eyelid changes shape, causing eyelashes to grow inward. Eyelashes that grow inward can cause friction in the eyes, especially in the cornea, so that the cornea is irritated and injured.
  • Corneal swelling. Corneas that are irritated due to trichiasis can be inflamed, so they experience stunting. Corneas that experience stiffness can look as clear as a normal cornea.

Symptoms of a trachoma will appear more severe on the upper eyelid compared to the lower eyelid. In trachoma that is already severe, other parts of the eye such as the tear gland can be infected. If the tear glands have been affected by trachoma symptoms, tear production can decrease and cause dry eyes, so that the symptoms of trachoma that occur can be more severe.

Causes Trachoma

This infection is caused by the bacterium Chlamydia trachomatis. This bacterium can actually be avoided and in the early stages the infection can be treated easily. But the infection becomes difficult to deal with if it has occurred in the human body for a long time.

Some of the factors that play a role in the transmission of trachoma are:

  • Poor cleanliness. Someone who lives in an unclean environment can be more susceptible to trachoma. Daily habits that are not clean, such as not paying attention to facial and hand hygiene, can also facilitate transmission of trachoma.
  • Living in a slum environment. Someone who lives in a slum environment is more prone to trachoma because contact between residents in the area is more prone to occur.
  • Living below the poverty line. People who live below the poverty line or live in poor countries are more prone to trachoma than people who live above the poverty line or live in developed countries.
  • Children who live in areas with trachoma sufferers are more prone to trachoma than adults
  • Women are more prone to trachoma than men, one of which is because women often make contact with children.
  • There is no adequate bathroom. The absence of adequate bathrooms in a settlement, both private and public bathrooms, causes transmission of trachoma between residents to occur more easily.

In addition to triggering infections in the eye, Chlamydia trachomatis bacteria can also be a cause of contagious sexually transmitted diseases in newborns. In the case of conjunctivitis, this bacterium is transmitted from mother to child during labor.

Trachoma Diagnosis

To diagnose a trachoma, the doctor will carefully examine the patient's eye condition. The doctor will also take a fluid sample from the patient's eye, then examine it under a microscope to determine the cause of the infection.

If positive is diagnosed with trachoma, the doctor will provide treatment according to the severity of the infection that occurs.

Infection that is still in its early stages, can be treated with drinking antibiotics. This antibiotic will kill the bacteria that causes the infection.

Trachoma Treatment

The trachoma treatment method will focus on antibiotics and surgery. But to help cure, patients also need to undergo other treatment methods. WHO prepares a series of trachoma treatments in the form of a SAFE strategy, which consists of:

  • Surgery is done to prevent complications of blindness due to trachoma, especially in patients who have entered the trichiasis stage. Eye surgery is done by an ophthalmologist by repairing the injured eyelid so it does not worsen irritation to the eye. If the cornea has suffered from trachoma, trachoma patients can undergo a corneal transplant.
  • Antibiotics aim to eradicate the Chlamydia trachomatis bacteria that causes trachoma in patients. The antibiotics given are azithromycin or tetracyclin. If in a neighborhood there are many children who experience trachoma, it is recommended that family members and the surrounding community also undergo treatment with antibiotics to prevent transmission
  • Face cleanliness (maintaining clean face area). Maintaining the cleanliness of the face area can reduce the severity of trachoma suffered, especially in children. In addition, by maintaining the cleanliness of the facial area, the spread of trachoma can be reduced.
  • Environmental improvement (maintaining environmental cleanliness). This step aims to maintain the cleanliness of the environment where trachoma patients live, especially the cleanliness of water. The other main step is to prevent the disposal of feces in any place that can increase the spread of trachoma. To prevent the spread of this disease through insects, families and communities around sufferers are also encouraged to use fly repellent devices around the house.

How Do You Prevent Trachoma?

This eye infection must be treated thoroughly to prevent infection from recurring and transmission. Maintaining personal and environmental cleanliness is the main key in its prevention.

One effective way to avoid this disease is to always wash your hands and face. This step will clean yourself from exposure to bacteria while reducing the risk of transmission of infection. Water used for daily needs must be clean and free of bacteria.

Managing waste and dirt well is also important, so that it is not a habitat for flies and other animals that have the potential to become a means of transmitting bacteria.

Handling as soon as possible on the trachoma is very important. If not treated immediately, this disease can trigger serious complications. Starting from the formation of scar tissue behind the eyes, damage to the cornea, to permanent blindness.

Therefore, the slightest disturbance in the eye should be consulted by a doctor, especially those that are sustainable or do not improve. Don't wait until your eyes get worse, so that dangerous complications can be avoided.

Trachoma complications

Trachoma infections that are not treated immediately or occur repeatedly can cause serious complications. Some of them:

  • Scarring on the inner surface of the eyelid.
  • Change in shape on the eyelids. The eyelids can fold inward (entropion) or eyelashes grow (trichiasis).
  • Scarring of the cornea or corneal ulcer.
  • Decreased vision to blindness.

Read Also : How to prevent and overcome tired eyes



References

References

1. Hu, et al. (2010). Epidemiology and Control of Trachoma: Systematic Review. Tropical Medicine & International Health.

2. Bashour, M. Medscape (2016). Ophthalmologic Manifestation of Chlamydia.

3. World Health Organization (2018). Trachoma.


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Is a health and wellness enthusiast. In him free time, she loves to travel and taste different types of teas.

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