Trachoma
Ophthalmology & Global Health: Infectious Blindness
1. Etiology & Transmission
Trachoma is caused by Chlamydia trachomatis (serotypes A, B, Ba, and C). It is the world’s leading infectious cause of blindness, primarily affecting impoverished regions with inadequate sanitation and limited water access. Transmission occurs via direct contact (eye-seeking flies, fomites, or fingers).
2. Clinical Manifestations (WHO SAFE Strategy context)
| Clinical Sign | Pathological Description |
|---|---|
| Follicular Inflammation | Immature lymphoid follicles on the upper tarsal conjunctiva. |
| Herbert’s Pits | Depressed, scarred limbal follicles following the resolution of inflammatory infiltrates. |
| Trachomatous Trichiasis | Inward-turning eyelashes secondary to scarring, causing chronic corneal abrasion and ulceration. |
3. Management & High-Yield Pearls
- The SAFE Strategy: WHO-endorsed approach: Surgery for trichiasis, Antibiotics (azithromycin), Facial cleanliness, and Environmental improvement.
- Complication: The blindness in trachoma is secondary to chronic corneal scarring and vascularization resulting from repeated trichiasis-induced trauma.
- Diagnostic Pearl: Suspect trachoma in endemic regions when patients present with chronic follicular conjunctivitis and superior corneal pannus (vascularization).
- Educational Resource: For global health management guidelines, clinical imaging, and practice questions, visit mymedschool.org.