Trachoma

Trachoma

Trachoma, trachomatous conjunctivitis, Egyptian eye inflammation, granular disease of the eyes: trachoma is a disease with many names. As different as it has names, it is also dangerous, because if left untreated, trachoma can lead to blindness when it reaches the final phase.

What is trachoma?

Trachoma is an eye disease in which, more precisely, the conjunctiva becomes chronically inflamed. Doctors differentiate between four stages with regard to the course. The first phase usually begins after an incubation period of up to two weeks has elapsed. This describes the time after infection until the onset of the first symptoms. For slang hf, please visit electronicsencyclopedia.com.

The onset of conjunctivitis (inflammation of the conjunctiva) is characteristic of this phase. In addition, there are other symptoms typical of conjunctivitis, such as a foreign body sensation in the eyes, reddened whites of the eyes and the formation of a secretion at the corners of the eyes, which indicates the excretion of bacteria that have already died. In the following second phase, lymph follicles form on the conjunctiva of the upper eyelids, so that the conjunctiva feels “rough”.

Furthermore, the eyes swell due to the ongoing inflammation; in extreme cases, the upper eyelids hang down in an unnatural way. In the third phase, the lymphatic follicles formed in the second phase rupture; The result is the formation of scars. If the trachoma remains untreated, the fourth and final phase of the disease occurs. The resulting scars literally pull the lids together, so that the lids have to give in to the pressure and the eyelashes protrude into the eyes.

With every blink of an eyelash, the eyelashes rub on the surface of the eye, which can become injured and inflamed when it comes into contact with other pathogens. If left untreated, serious eye injuries can be caused here, which can lead to blindness as a result of trachoma.

Causes

Trachoma is caused by serotypes A, B and C of the bacterium Chlamydia trachomatis. The bacterium is mainly found in regions with poor hygienic conditions. Due to this fact, trachoma is considered largely eradicated in industrialized countries.

As a bacterium, the pathogen prefers a warm, humid environment. Since infection can occur solely through smear infection with people who are already infected or with contaminated objects, shared towels, clothing and public washing places are considered sources of infection for trachoma.

Symptoms, Ailments & Signs

The bacterium that causes the disease has an incubation period of five to 12 days, after which individual symptoms are similar to conjunctivitis or irritation, such as a red eye. Without reinfection, however, the inflammation gradually subsides.

Conjunctivitis is known as “active trachoma” and is particularly common in preschool children. It is characterized by white lumps on the underside of the upper eyelid, as well as nonspecific inflammation and thickening, often with bulges. Active trachoma is often associated with a watery discharge. A secondary bacterial infection can occur and cause a purulent discharge.

The later structural changes of trachoma are called “scarring trachoma”. These include scars in the eyelid that lead to distortion of the eyelid. Most often, children with active trachoma are asymptomatic because the mild irritation and ocular discharge are often mistaken for normal.

However, other symptoms may include: eye discharge, swollen eyelids, trichiasis (eyelashes rubbing against the eyeball), swelling of the lymph nodes in the front of the ears, sensitivity to bright light, increased heart rate, other throat and nose complications. The main complication is the so-called corneal ulcer, which arises due to excessive rubbing or trichiasis with superimposed bacterial infection.

Diagnosis & History

One of the first diagnostic measures of trachoma is the clinical picture. Advanced cases in particular can be identified with a visual diagnosis due to their relatively relevant clinical picture.

Statements by the patient that the symptoms occur again and again are considered reliable indications of the presence of trachoma. Nevertheless, precisely because of the severe consequences of a misdiagnosis, it must not stop there. Therefore, a swab is added as a further diagnostic measure. Here, tiny tissue samples are taken from the conjunctiva of the affected person and examined in the laboratory for possible pathogens.

If the pathogen Chlamydia trachomatis is detected, it can then be assumed with absolute certainty that it is trachoma. This diagnosis is particularly important insofar as cases of the disease in the early stages of trachoma look deceptively similar to ordinary conjunctivitis.

When should you go to the doctor?

Disturbances in the functional activity of the eyes are signs of a health impairment. If they persist or increase in volume and intensity, a doctor is needed. If there is a loss of vision due to an overload situation, rest or a rest phase is sufficient in most cases. If vision is completely restored afterwards, there is no need to consult a doctor. If impairments persist even after a break, the cause needs to be clarified.

Elevated body temperature, irritability, reddening of the eyes or swelling of the lymph should be examined and treated. Hypersensitivity to the effects of light, tachycardia or general irregularities in the heart rhythm should also be presented to a doctor. Changes in eye discharge, dryness in the eye, or eyelid abnormalities should be reported to a doctor. In case of itching, general discomfort and swollen eyes, a doctor’s visit is necessary. If there is a headache, a feeling of pressure in the area of ​​the eyes or blurred vision, medical examinations are required for a diagnosis.

Behavior abnormalities, unsteady gait or an increased risk of accidents are signs of a health problem. If everyday tasks can no longer be performed due to the impairment of vision, the person concerned needs help. A doctor must be consulted so that the necessary measures can be taken. Otherwise, in severe cases, there is a risk of blindness.

Treatment & Therapy

Since trachoma is a bacterial disease, it is considered to be easily treatable if treated in good time. The World Health Organization (short: WHO) recommends the so-called “SAFE therapy”.

The “S” stands for Surgery. The eye injuries that occur in the last stage as a result of the deformation of the eyelids should be surgically removed in order to prevent eye injuries as one of the basic prerequisites for later complications. The “A” stands for antibiotics, with which the trachoma pathogen is to be killed.

The “F” for facial cleanliness or hygienic environment of the field of vision pursues the goal of at least preventing further infections of the already weakened eye area by keeping the facial skin as germ-free as possible. Finally, the “E” stands for Environmental Improvement, which means compliance with basic hygienic rules. After all, poor hygiene conditions are the main cause of the spread of trachoma.

Prevention

Trachoma is considered largely eradicated in Europe. The main reason for this is the high hygiene standards. But this does not only include regular hand washing. Risk groups in particular, such as contact lens wearers, should pay attention to special safety measures. For example, contact lenses should not be shared with strangers.

The same applies to all other items of common use that are also suitable for use on the face, such as the example of bath towels already mentioned. If, despite this, there is contact with a possible carrier of the pathogen, disinfecting the hands with 70 percent alcohol-based skin disinfectants is sufficient to kill the trachoma pathogens on the skin.

Aftercare

Treatment recommendations for aftercare for trachoma do not exist. Because in the final stage of the disease, the person affected is blind. Basically, he is then considered helpless and has to learn to deal with his blindness in everyday life. In order to learn how to deal with blindness, the person concerned must first receive regular psychological care.

In addition, he is dependent on an accompanying person to carry out everyday tasks. However, trachoma is a gradual process. If the trachoma is diagnosed in good time and treated in good time (with antibiotics or surgery on the upper lid of the eye), it can be the task of follow-up care to prevent the eye from developing again. Follow-up care then includes preventive measures.

It is important to eliminate the causes of the disease. Poor hygienic conditions almost exclusively trigger trachoma. Improving general hygiene measures and adequate personal hygiene can counteract a new illness during follow-up care.

In particular, the face should be washed regularly and general hygiene should be checked. For domestic hygiene, norms and standards should be developed and adhered to in order to avoid smear infections. Flies can also trigger the disease. For follow-up care in the case of trachoma, its spread must be contained by disinfecting measures.

You can do that yourself

Adhering to everyday tips can sometimes prevent the occurrence of a disease or even contribute to recovery. It is therefore not always necessary to consult a doctor.

The best way to manage the symptoms of trachoma is to maintain basic hygiene standards. These are omnipresent in western industrialized nations, which is why the disease rarely occurs here. When traveling to countries with insufficient water supply, people should definitely prefer accommodation in the upper category. One should never sleep in already used beds. Towels that come into contact with the eye must be fresh. In addition, the use of disinfectants is recommended. There is a minimal risk in this country for contact lens wearers. Contagion is prevented by hygienic storage and use of the visual aids.

If you develop trachoma, you should definitely see a doctor. Self-treatment is not advisable. In the worst case, there is a risk of blindness if the disease recurs over a period of years. Only drug therapy with antibiotics is suitable. Other alternative healing methods apart from basic recommendations such as rest and a balanced diet are not known.

Trachoma