Trachoma - Diagnosing and treating trachoma

Trachoma can usually be diagnosed by visually examining a person's upper eyelids.

If there's any doubt, further tests can be carried out by taking a sample of discharge and testing it for the presence of the Chlamydia trachomatis bacteria.

Treatment plan

The World Health Organization (WHO), which aims to eliminate trachoma by 2020, recommends using a community-focused initiative called "SAFE" to manage the condition. SAFE stands for:

• Surgery – to repair damage to the eye
• Antibiotics – to treat the infection
• Face washing – to reduce the spread of infection
• Environmental changes – such as providing access to clean water and suitable sanitation

Because trachoma is highly contagious, an entire community will usually need to be treated to stop it from spreading.

Face washing and environmental changes

Regular face washing removes the contagious discharge from the eyes and reduces the risk of the infection spreading through physical contact and flies. However, people are often reluctant to wash their faces regularly if clean water is limited.

Improving access to clean water and washing facilities and reducing the local fly population can help limit the spread of infection.  

Much of this work is carried out by charities, voluntary organisations and other non-governmental organisations (NGOs), such as:

• Sightsavers – an international charity that's working to eliminate conditions that can cause blindness
• WaterAid – a charity that seeks to provide clean water and safe sanitation facilities to the world's poorest people

Antibiotics

Both antibiotic ointments (topical antibiotics) and tablets (oral antibiotics) can be used to treat trachoma.

The WHO recommends that if 10% or more of the children in a community have trachoma, everyone in the community should be treated with antibiotics to prevent re-infection.

Surgery

Surgery will be used in cases where scarring of the eyelids is causing the eyelashes to turn inwards. During surgery, a cut is made in the upper eyelid and the eyelashes are turned away from the cornea.

It's a relatively straightforward procedure carried out under local anaesthetic, and takes around 15 minutes to complete.  

Where there is visual impairment, it may be possible to restore some vision with a cornea transplant. This involves removing the damaged corneas and replacing them with corneas from a suitable donor. However, access to this type of surgery is usually unavailable in places where trachoma is widespread.