Trachoma is a chronic infectious conjunctival keratitis caused by Chlamydia trachomatis, which is named because of the rough and uneven appearance of the lid conjunctiva, resembling sand grains. In the early stages of the disease process, there is infiltration of the conjunctiva, such as papillae and follicular hyperplasia, along with corneal vascular opacification; in the late stages, scarring of the affected lid conjunctiva occurs, resulting in inversion of the eyelid deformity, which aggravates the damage to the cornea and can seriously affect vision or even cause blindness. The incubation period is 5 to 14 days, both eyes are affected, and it occurs mainly in childhood or adolescence.
Although trachoma is an eye disease caused by Chlamydia, most are also associated with poor hygiene. Therefore, even if there is no vision problem, it is still necessary to wear a pair of glasses when you go out usually if only for daily protection, we can choose cheap glasses.
What are the typical symptoms of trachoma?
1, Primarily acute onset, with foreign body sensation, photophobia, lacrimation, more mucus, or mucopurulent discharge.
2, After a few weeks, the acute symptoms subside and enter the chronic stage, when there is no discomfort or the eyes only feel easily fatigued.
3, in the chronic course of the disease, there are often repeated infections, and the disease is aggravated. When there is active vascular opacity on the cornea, the irritation symptoms become significant, and the vision is diminished.
4, Late, often due to sequelae, such as lid entropion, impingement, corneal ulcers, and dry eyes, the symptoms are more pronounced and seriously affect vision and even blindness.
Types of trachoma
Acute trachoma: acute follicular conjunctivitis symptoms, eyelid redness, and swelling, highly congested conjunctiva, rough and uneven lid conjunctiva due to papillomatous hyperplasia, upper and lower dome conjunctiva full of follicles, combined with diffuse corneal epithelioid and preauricular lymph node enlargement, which can turn into chronic phase after a few weeks.
2. Chronic trachoma: the disease can be prolonged for several years to more than ten years due to repeated infections, with reduced congestion, papillary hyperplasia, and follicular formation, with follicles of varying sizes, which can be gelatinous, with significant lesions in the upper dome and upper edge of the lid conjunctiva, as well as in the lower lid conjunctiva and lower dome conjunctiva, and in severe cases even invading the meniscus.
What complications does trachoma cause?
1. Entropion and impingement: In the later stages of trachoma, the lesion may invade the lid plate and become shorter due to contraction of the scar tissue, and the lid conjunctiva, especially the superior lid furrow, shrinks due to the scar, causing the lid plate to bend inward like a boat, forming a typical entropion of the lid. Ingrown eyelashes can also occur alone due to scarring near the hair follicle after the invasion of the lesion. Long-term irritation of impingement can cause diffuse punctate infiltration of the superficial layer of the cornea, followed by epithelial peeling and ulceration, called trachomatous keratitis or a trachomatous corneal ulcer. At this time, patients appear foreign body sensations, photophobia, lacrimation, pain, blurred vision, and other symptoms.
2. Trachomatous corneal ulcer: at the end of the vessels, there is a grayish-white dotted infiltration; once broken, that is, the formation of shallow ulcers, these ulcers can fuse with each other to form small grooved ulcers. These ulcers can fuse with each other to form small sulcular ulcers. This type of ulcer caused by the trachoma vessels, along with those caused by impingement, is called a trachomatous corneal ulcer.
3. Ptosis: Ptosis occurs due to hyperplasia of the upper eyelid conjunctiva and lid plate tissue, which increases the weight of the upper eyelid; at the same time, the lesion invades the Muller’s muscle and the levator muscle, which weakens the lid lifting function.
4. Trachomatous ocular dryness: due to scarring of the conjunctival surface, the lacrimal gland and cup cells of the conjunctiva are completely destroyed, the opening of the lacrimal drainage duct in the upper fornix is also closed, mucus and tears disappear completely, the conjunctiva and cornea become dry, and in severe cases, the conjunctiva and cornea are diffusely and substantially cloudy, the epithelium is keratinized and hypertrophied, resembling skin, and vision is extremely reduced.