TRACHOMA

Ekata karkiBSN 2ND yearHope international collegeTRACHOMA

It is a chronic conjunctivitis due to repeated infection with Chlamydia trachomatis, serotypes A, B, and C.

Trachoma

Conjunctiva: It is the clear mucous membrane covering the sclera (white part of eye) and interior lining of eyelids . It contains many goblet cells which secrets mucin that keep the eye moist.Conjunctivitis: Conjunctivitis is the inflammation of the conjunctiva. The inflammation of the conjunctiva cause the eyes blood vessels to dilate, resulting in the reddish appearance. Quick review:

Inflammation from active trachoma infection tarsal plate scarring eyelashes to turn in.

The lashes rub on the cornea, producing ulceration, scarring, and blindnessPathophysiology:

EyedischargeSwollen eyelidsTrichiasis(turned-in eyelashes)Swelling oflymph nodesin front of the earsSensitivity to bright lightsIncreased heart rateFurther ear, nose and throat complication

Sign & symptoms:

The disease usually occur at : poor dry areas of the world in which there is inadequate water supply and poor community sanitation. poverty , crowding Most transmission of trachoma occurs within the family.Mode of transmission:

Flies: flies go from individual to individual

Fingers: direct contact with ocular discharge

Family: within the family, child to child

3 Fs for transmission:

Trachoma StagesNormal Conjunctiva (as described earlier )

Trachomatous inflammation follicular (TF): the presence of five or more follicles(round swellings that are paler than the surrounding conjunctiva) in the upper tarsal conjunctiva.

Trachomatous inflammation intense (TI): Obvious inflammatory thickening of the tarsal conjunctiva that obscures more than half of the normal deep tarsal vessels.

Trachoma Stages cntTrachomatous scarring (TS): the presence of scarring in the tarsal conjunctiva. Scars are easily visible as white lines, bands, or sheets in the tarsal conjunctiva. Trachomatous trichiasis (TT): at least one eyelash rubs on the eyeball. Corneal opacity (CO): easily visible corneal opacity over the pupil. The pupil margin is blurred viewed through the opacity.

Antibiotics : AzithromycinSurgery : A bilamellar tarsal rotation procedure is warranted to direct the lashes away from the globe.Early intervention is beneficial as the rate of recurrence is higher in more advanced disease.Lifestyle measures

Treatment:

Educate the publicImprove basic sanitationProvide adequate case finding and treatment facilities; with emphasis on preschool children.Improving life style measurePreventing complicationAvoiding risk factor

Prevention: