Synonyms
Greek: trachôma, trachus – “rough”, English : trachoma conjunctivitis trachomatosa, trachomatous inclusion conjunctivitis, Egyptian eye inflammation, granular disease of the conjunctiva
Definition Trachoma
Trachoma is a chronic conjunctivitis caused by the bacterium Chlamydia trachomatis, which often leads to blindness.
How common is trachoma?
Trachoma is very rare in Europe and is notifiable here. In India, Africa and the developing countries of the southern Mediterranean Sea, however, it is still one of the most common causes of blindness, affecting about 4% of the population, and the most common infectious cause of blindness worldwide. In Egypt, China and India alone, there are approximately 500 million people suffering from this disease.
What are the symptoms of trachoma?
After initial infection with C. trachomatis, which in endemic areas mainly affects small children, non-specific weeping (serous) conjunctivitis with foreign body sensation develops within 5-7 days. Soon afterwards, large granular accumulations of inflammatory cells (follicles) form on the conjunctiva of the upper eyelid, which look gelatinous, grow massively and finally burst open. In this way, the infectious fluid (secretion) trapped in the follicles is drained to the outside.
After the follicles burst open, scars appear, which leads to a shrinking of the conjunctiva of the upper eyelid, pulling the upper lashes inwards (entropion). Due to the mentioned follicles, the surface of the conjunctiva of the upper eyelid appears rough, where the name trachoma comes from. The inflammation affects the conjunctiva of the eyelid and the transitional fold, but not the conjunctiva above the eyeball.
The nodular elevation (caruncle) and the conjunctival fold in the corner of the nose are often clearly swollen. From the upper corneal edge, a gelatinous cloudiness interspersed with follicles grows over the cornea. This cloudiness is called “pannus from above” or pannus on the eye.
The entropion causes the eyelashes to rub on the cornea and create a corneal ulcer (corneal ulcer). The final stage of a severe trachoma is a porcelain-like corneal scar, which consists of degenerated conjunctival and corneal cells with few blood vessels. It is caused by drying of the surface of the eyeball and recurrent erosions.
The advanced stages as well as the final stage of the disease develop over the course of several years. Based on the severity of the symptoms, the World Health Organization (WHO) proposes the classification of trachoma into 5 clinical stages: In addition, superinfection by bacteria such as Haemophilus, Moraxella, Pneumococcus and Streptococcus can always occur, which can aggravate the clinical picture of trachoma both primarily and in the chronic stage.
- Follicular trachomatous inflammation in 5 or more follicles of the conjunctiva of the upper eyelid,
- Severe trachomatous inflammation with pronounced inflammatory thickening of the conjunctiva of the upper eyelid,
- Trachomatous, conjunctival scarring in visible scars of the conjunctiva of the upper eyelid,
- Trachomatous trichiasis when rubbing at least one eyelash on the eyeball,
- Corneal turbidity
