Ver el código de «Trachoma»

==Background==
*'''Most common cause of infectious blindness worldwide'''
*Caused by Chlamydia trachomatis
**Spread by direct contact, fomites (towels, clothes, bed covers), and flies (those that have landed on or near the mouth or eyes of other infected individuals)
*More than 6 million blind secondary to trachoma and more than 150 million in need of treatment
*Typically affects most marginalized populations in the world
**Those with limited access to clean water and sanitation
**Part of the group of diseases known as [[neglected tropical diseases]]

==Clinical Features==
===Acute===
*Conjunctivitis like symptoms
**Conjunctival follicles (white lumps) on the inner upper eyelid
**Non-specific inflammation and thickening of the conjunctiva

===Chronic===
*Known as the "quiet disease" because of its slow chronic course
*Blindness after repeated infections
**Caused by structural changes to the inner eyelid
***Scarring of the inner eyelid that leads to buckling of the lid
****This causes the eyelashes to turn inwards '''(Trichiasis)''' and rub on the cornea causing repetitive trauma that leads to opacities and scarring of the cornea 
*Major complications include corneal ulcers

==Diagnosis==
*Clinical diagnosis
====WHO classification====
*Simplified grading system composed of 5 clinical signs of infection
**Follicular trachomatous inflammation (TF)
***≥5 follicles >0.5mm on the superior tarsal conjunctiva
**Intense trachomatous inflammation (TI)
***Hypertrophy of the papilla and inflammatory thickening of the superior tarsal conjunctiva (must obscure more than half of the deep vessels)
**Trachomatous scarring (TS)
***Scarring in the superior tarsal conjunctiva
**Trachomatous trichiasis (TT)
***One or more ingrown eyelash in contact with the globe or evidence of eyelash loss (epilation)
**Corneal opacity
***Must blur part of the pupil margin

==Treatment==
*'''S.A.F.E.''' strategy proposed by WHO
**'''S''' - Surgery
***Bilamellar tarsal rotation procedure recommended by WHO
**'''A''' - Antibiotics
***Tetracycline 1% eye ointment
****'''Compliance issues''' secondary to difficulty in use and uncomfortable to apply
***Azithromycin (20mg/kg) single dose
****Relatively expensive in resource poor settings
**'''F''' - Facial cleanliness
***Helps decrease disease transmission
**'''E''' - Environmental management
***WHO emphasizes access to latrine and clean water

==See Also==
*[[Parasites]]
*[[Travel Medicine]]
*[[Neglected Tropical Diseases]]

==Source==
*http://www.cdc.gov/healthywater/hygiene/disease/trachoma.html
*http://www.cartercenter.org/health/trachoma/index.html
*http://webcache.googleusercontent.com/search?q=cache:http://whqlibdoc.who.int/publications/2006/9241546905_eng.pdf
*http://www.who.int/topics/trachoma/en/

[[Category:ID]]
[[Category:TropMed]]