Trachoma in children

Trachoma is an eye infection, which easily spreads from person to person. It is caused by bacteria, and affects the eyelids, cornea and conjunctiva (outside covering of the eye).

It is associated with poverty and lack of proper hygiene. Trachoma is caused by the bacteria chlamydia trachomatis.

 It is the leading infectious cause of blindness in the world, mostly among children. Trachoma is spread by direct or indirect contact with eye, nose or throat secretions of an individual with trachoma or indirectly via flies or other insects carrying those secretions on their legs or bodies.

Common denominators are poor hygiene, unsanitary water supplies and shared towels.

It is most common in children (three to five years of age) who spread it to their siblings, mothers and playmates.

In endemic areas, the incidence of the infection is highly variable from village to village and concentrates in families or other pockets.

Once infected, the conjunctiva becomes red and irritated. Repeated infections are common and, unless treated, can result in scars forming on the surface of the conjunctiva.

The lids become scarred and the lid margins may turn in, causing eye irritation and pain followed by scarring of the cornea by the in-turned lashes (trichiasis), which scrape the cornea. Corneal scarring results in decreased or total loss of vision.

For treatment of trachoma, the World Health Organisation developed the SAFE strategy (S = surgical care A = antibiotics F = facial cleanliness E = environmental improvement).

Treatment involves screening communities for the presence of trachoma in children aged one to nine years. When over ten per cent are found to have clinical disease, the entire community is treated with antibiotics.

Prevention of vision loss requires adequate, prompt treatment, in addition to education and teaching proper hygiene to the parents and children. Blindness from trachoma is preventable at relatively low cost. Apart from hygiene, all infected individuals within a heavily infected community should be treated with oral antibiotics or antibiotic eye ointment early in the disease process.