Materiały źródłowe

• #1

  https://www.aao.org/eye-health/diseases/what-is-trachoma

  Trachoma is an eye infection affecting both eyes. It is the worlds leading cause of infectious blindness. A bacterium called Chlamydia trachomatis causes trachoma. In its early stages, trachoma causes conjunctivitis (pink eye). Early symptoms begin to appear within five to 12 days of exposure to the bacterium. These symptoms can include: mild itching and irritation of the eyes and eyelids, and a discharge from the eyes. As the infection progresses, it causes eye pain and blurred vision. If the infection is untreated, scarring occurs inside the eyelid. This leads to the eyelashes turning inward toward the eye. This condition is called trichiasis. The eyelashes brush and scratch against the cornea, the clear, dome-shaped window at the front of the eye. This continual irritation turns the cornea cloudy. It can lead to the development of corneal ulcers and vision loss. Having one episode of trachoma rarely causes problems. Ophthalmologists think that repeated infections lead to the scarring and blinding complications. Generally, it takes years before trachoma can cause vision loss.

• #1

  https://sales-demo.adam.com/content.aspx?productid=141&pid=1&gid=001486

  Trachoma is an infection of the eye caused by bacteria called chlamydia. […] Symptoms begin 5 to 12 days after being exposed to the bacteria. The condition begins slowly. It first appears as inflammation of the tissue lining the eyelids (conjunctivitis, or „pink eye”). Untreated, this may lead to scarring. […] Symptoms may include: Cloudy cornea, Discharge from the eye, Swelling of lymph nodes just in front of the ears, Swollen eyelids, Turned-in eyelashes. […] Outcomes are very good if treatment is started early before scarring and changes to the eyelids develop. […] If the eyelids become very irritated, the eyelashes may turn in and rub against the cornea. This can cause corneal ulcers, additional scars, vision loss, and possibly, blindness.

• #1 Trachoma – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/trachoma/symptoms-causes/syc-20378505

  At first, trachoma may cause mild itching and irritation of your eyes and eyelids. Then you may notice swollen eyelids and pus draining from the eyes. Untreated trachoma can lead to blindness. […] Young children are particularly susceptible to infection. But the disease progresses slowly, and the more painful symptoms may not emerge until adulthood. […] All the signs of trachoma are more severe in your upper lid than in your lower lid. Without intervention, a disease process that begins in childhood can continue to advance into adulthood.

• #1 Trachoma – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/trachoma/trachoma+-+including+symptoms%2C+treatment+and+prevention

  Trachoma is a preventable disease of the eyes caused by infection with the bacteria Chlamydia trachomatis (different from the sexually transmitted form of this germ). It causes loss of vision and blindness in older people who have had severe active trachoma, usually since childhood. […] Active trachoma in children often causes no symptoms. Trachoma can be present even in children with clean faces. However, children with active trachoma may have red, sore, sticky eyes and discharge from the nose. […] The cycle of repeated active infection and resolution occurs over many years. As trachoma progresses in teenagers and young adults, scarring develops under the eyelids. Without treatment the eyelashes turn in and rub on the cornea (the clear part of the front of the eye). This is called trichiasis, and may be painful. Eventually this will cause scarring of the cornea, followed by loss of vision and blindness.

• #1 Trachoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559035/

  Trachoma is a debilitating eye disease caused by the Chlamydia trachomatis bacterium and is one of the leading causes of blindness worldwide. Trachoma predominantly affects the conjunctiva, and the infection results in inflammation, roughening, and scarring of the inner surface of the eyelids, along with erosion of the corneal surface. […] If the condition is left untreated, ocular complications can progress to blindness. […] Trachoma manifests in 2 distinct stages, each presenting unique symptoms and complications. First-phase symptoms: These symptoms include persistent keratoconjunctivitis characterized by inflammation of the conjunctiva, known as active trachoma. […] Second-phase symptoms: The progression to the second stage of the illness is marked by periods of intense conjunctival inflammation, leading to eyelid scarring. Trichiasis is a disorder in which the eyelashes rotate inward and come in touch with the eyeball due to scarring. […] Inverted eyelashes that scratch the cornea increase the risk of corneal opacity and visual problems, leading to blindness in severe chronic conditions.

• #1 Trachoma – EyeWiki

  https://eyewiki.org/Trachoma

  Trachoma is the most common infectious cause of blindness in the world caused by recurrent ocular surface infections and secondary scarring of the ocular surface by the bacterial organism Chlamydia trachomatis. […] Most individuals are asymptomatic or have mild protean symptoms depending on the level of inflammation. Symptoms, if present, are similar to those seen in any chronic conjunctivitis and include chronic redness, discomfort, tearing, photophobia and mucopurulent discharge and visual loss in the late stages. […] Blindness from trachoma is due to recurrent episodes of active infection over months to years. The initial infection is confined to the conjunctival epithelium and triggers an immune response presenting as conjunctival follicles. Repeated infections with subsequent inflammatory responses results in tissue destruction with fibrosis and contraction, cicatricial entropion with trichiasis and lash corneal touch resulting in corneal erosions, ulcerations, scarring and vascularisation resulting in corneal opacification and resultant blindness.

• #1 What Is Trachoma Disease and How Does It Cause Blindness? | Orbis

  https://www.orbis.org/en/avoidable-blindness/trachoma-trichiasis

  Trachoma is an infectious eye disease and one of the leading causes of blindness globally. If left untreated it can develop into trichiasis – a painful condition where the eyelids turn inwards and the eyelashes rub against the surface of the eye leading to irreversible blindness. […] Trachoma can lead to trachomatous trichiasis in the later stages of the infection. Trachomatous trichiasis can occur when repeated infections of the inner part of the upper eyelid cause the upper eyelid to turn inwards so that eyelashes scrape on the eyeball – resulting in excruciating pain and permanent scarring of the front of the eye (the cornea). If left untreated trachomatous trichiasis will lead to blindness in most cases. […] The signs of trachoma are classed into five stages. These are: Stage 1: Trachomatous Inflammation – Follicular (TF) At the beginning, five or more follicles small bumps that contain lymphocytes, a type of white blood cell are visible with magnification on the inner surface of your upper eyelid (conjunctiva). Stage 2: Trachomatous Inflammation – Intense (TI) The eye is now highly infectious and becomes irritated with a thickening or swelling of the upper eyelid. Stage 3: Trachomatous Scarring (TS) Repeated infections lead to scarring of the inner eyelid. The scars often appear as white lines when examined with magnification. The eyelid may become distorted and may turn in (entropion). Stage 4: Trachomatous Trichiasis (TT) The scarred inner lining of your eyelid continues to deform, causing eyelashes to turn in so that they rub on and scratch the transparent outer surface of the eye (cornea). Stage 5: Corneal Opacity (CO) The cornea becomes affected by an inflammation that is most commonly seen under your upper lid. Continual inflammation made worse by scratching from the in-turned lashes leads to clouding of the cornea.

• #1

• #1 Trachoma: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/25148-trachoma

  Trachoma is an eye disease caused by a bacterium called Chlamydia trachomatis. The infection can cause irreversible blindness. […] Signs and symptoms of early stages of trachoma include: Red and irritated eyes. Swollen eyelids. Blurred vision. Watery discharge from the eyes. Discharge from the nose. […] Advanced trachoma, or trachomatous trichiasis, happens after you have repeated infections and bouts of inflammation. The inflammation causes scar tissue on the inside of your eyelids and misdirection of your eyelashes, both of which scrape against your cornea. […] Signs and symptoms of advanced trachoma include: Tightened eyelids due to scar tissue. Inward-turning eyelashes because of the tight eyelids. Extreme eye pain caused by eyelashes scraping against your cornea. Light intolerance. Impaired vision, possible blindness.

• #1 Trachoma | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/trachoma-16689733.html

  Stage 1: trachomatous inflammation – follicular (TF) Presence of five or more follicles in the upper tarsal conjunctiva. Follicles are whitish, grey or yellow elevations, paler than the surrounding conjunctiva. […] Stage 2: trachomatous inflammation – intense (TI) The upper tarsal conjunctiva is red, rough and thickened. The blood vessels, normally visible, are masked by a diffuse inflammatory infiltration or follicles. […] Stage 3: trachomatous scarring (TS) Follicles disappear, leaving scars: scars are white lines, bands or patches in the tarsal conjunctiva. […] Stage 4: trachomatous trichiasis (TT) Due to multiple scars the margin of the eyelid, usually the upper lid, turns inwards (entropion); the eyelashes rub against the cornea and cause ulcerations and chronic inflammation. […] Stage 5: corneal opacity (CO) Cornea gradually loses its transparency, leading to visual impairment and blindness.

• #1 Trachoma | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-022-00359-5

  Trachoma is a neglected tropical disease caused by infection with conjunctival strains of Chlamydia trachomatis. It can result in blindness. Pathophysiologically, trachoma is a disease complex composed of two linked chronic processes: a recurrent, generally subclinical infectious inflammatory disease that mostly affects children, and a non-communicable, cicatricial and, owing to trichiasis, eventually blinding disease that supervenes in some individuals later in life. At least 150 infection episodes over an individual’s lifetime are needed to precipitate trichiasis; thus, opportunity exists for a just global health system to intervene to prevent trachomatous blindness. […] The disease can be conceptualized as progressing in two phases. In the first phase, repeated infection with conjunctival strains of the bacterium Chlamydia trachomatis (Ct) results in a chronic keratoconjunctivitis (inflammation of the cornea and conjunctiva), including an inflammation of the conjunctiva known as active trachoma. Rounds of severe conjunctival inflammation lead to scarring of the eyelid, which is the start of the second disease phase. This scarring can cause inward rotation of the eyelashes so that they come into contact with the eyeball, a condition known as trichiasis. Trichiasis may be accompanied by a distortion of the eyelid known as entropion, in which part or all of the eyelid margin is rolled inward. Scratching of the cornea by in-turned eyelashes predisposes to corneal opacity, vision impairment and blindness.

• #1 Trachoma | Nature Reviews Disease Primers

  https://www.nature.com/articles/s41572-022-00359-5

  The limited longitudinal data available indicate that a primary infection episode in a child is characterized by a short preclinical phase of a few days before the development of signs of inflammation. In adult human volunteer experiments, clinical inflammation developed ~10 days after conjunctival Ct inoculation. Established infections are characterized, particularly in younger preschool age children, by a generalized follicular and papillary conjunctivitis, particularly evident in the conjunctiva of the upper eyelid. […] The different time courses of conjunctival infection and active trachoma explain the partial mismatch observed between infection and disease at the individual level. This disparity has important implications for trachoma programmes, as individually targeted antibiotic treatment decisions based on observable conjunctival inflammation of at least moderate intensity would miss many infected individuals with a mild clinical response. Antibiotic mass drug administration (MDA) is the most practical way of trying to treat all individuals infected with conjunctival Ct within large trachoma-endemic populations.

• #1

  https://www.who.int/news-room/fact-sheets/detail/trachoma

  In areas where trachoma is endemic, active (inflammatory) trachoma is common among preschool-aged children, with prevalence rates which can be as high as 6090%. […] After years of repeated infection, the inside of the eyelid can become so severely scarred (trachomatous conjunctival scarring) that it turns inwards and causes the eyelashes to rub against the eyeball (trachomatous trichiasis), resulting in constant pain and light intolerance. This and other alterations of the eye can lead to scarring of the cornea. Left untreated, this condition leads to the formation of irreversible opacities, with resulting visual impairment or blindness. […] The age at which this occurs depends on several factors including local transmission intensity. In very highly endemic communities it can occur in childhood, though onset of visual impairment between the ages of 30 and 40 years is more typical.

• #1 Risk factors for the progression of trachomatous scarring in a cohort of women in a trachoma low endemic district in Tanzania

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8604323/

  Trachoma, a chronic conjunctivitis caused by Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. […] The rate of development of trachomatous trichiasis, the potentially blinding late-stage trachoma sequelae, depends on the rate of trachomatous scarring development and progression. […] The overall cumulative 3.5-year progression rate of scarring was 35.3% (95% CI 31.6-39.1). […] The 3.5-year progression of scarring among women in Kongwa, a formerly hyperendemic now turned hypoendemic district in central Tanzania, was high despite a low active trachoma prevalence. […] Our findings suggest that once scarring has developed it continues to progress irrespective of the current trachoma environment. […] The cumulative progression rate of scarring increased steadily with age until age 50 (test for trend, p = 0.011).

• #1

  https://www.who.int/news-room/fact-sheets/detail/trachoma

  Visual impairment or blindness results in a worsening of the life experience of affected individuals and their families, who are normally already amongst the poorest of the poor. Women are blinded up to 4 times as often as men, probably due to their close contact with infected children and their resulting greater frequency of infection episodes.

• #1 Risk factors for the progression of trachomatous scarring in a cohort of women in a trachoma low endemic district in Tanzania | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0009914

  Our findings suggest that once scarring has developed it continues to progress irrespective of the current trachoma environment. […] The cumulative progression rate of scarring increased steadily with age until age 50 (test for trend, p = 0.011). […] The age adjusted logistic regression predicting odds of TS progression, adjusted for baseline TS severity, showed a significant association of TS progression with older age in those younger than 50 years of age, an increased risk with an increase in household poverty index, and the presence of an indoor cooking fire.

• #1 Trachoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559035/

  The pathophysiology of trachoma is characterized by the development of conjunctival scarring, which results from recurrent cycles of tissue repair and inflammation. […] Without treatment for this fibrotic scarring, complications such as eyelid entropion (inward turning of the eyelid) and trichiasis (misalignment of the lashes) may occur, potentially resulting in corneal abrasions, ulcerations, and eventual blindness. […] Undiagnosed or improperly managed trachoma can cause several issues that can eventually lead to blindness and permanent vision impairment. […] Trichiasis refers to the misalignment of lashes, leading to repetitive abrasion of the corneal surface with each blink. […] Without proper treatment, trichiasis can progress to corneal opacities and eventual blindness.

• #1 Everything You Need To Know About Trachoma – Anaheim Eye Institute

  https://anaheimeyemd.com/everything-you-need-to-know-about-trachoma/

  Without a specialized search for it, trachoma may go unnoticed because some affected individuals are asymptomatic (without symptoms). […] Without medical intervention, persistent infections and inflammation can result in corneal scarring and inversion of the eyelids, which causes the eyelashes to rub against the eye with each blink. Trichiasis is an advanced form of trachoma, and the pain can be so severe that many people tear out their eyelashes to lessen the discomfort of blinking. Trichiasis might eventually result in vision loss and irreversible blindness if not addressed.

• #1 Trachoma – MD Searchlight

  https://mdsearchlight.com/eye-health/trachoma/

  Trichiasis: This is when eyelashes grow in the wrong direction and rub on the surface of the eye. Over time, this repeated rubbing can cause corneal sores, ulcerations, and scarring. Without treatment, this can progress to cause cloudiness of the front of the eye and blindness. […] Entropion: This complication happens when the eyelid turns inward, causing eyelashes to scrape the surface of the eye. This can lead to discomfort, corneal sores, and risk of blindness if not treated. Entropion can occur because of advanced scarring and recurrent infections from trachoma. […] Corneal opacities: These occur due to prolonged inflammation and scarring of the cornea. This cloudiness of the cornea can cause reduced vision and possibly irreversible vision loss. […] Blindness: Trachoma can eventually lead to irreversible blindness if not treated or managed properly. This not only affects the individual but also has major socio-economic impact on their community.

• #1 Trachoma: how a common cause of blindness can be prevented worldwide – Our World in Data

  https://ourworldindata.org/trachoma-how-a-common-cause-of-blindness-can-be-prevented-worldwide

  Hundreds of thousands of people worldwide are blind because of a disease called trachoma. Trachoma is caused by repeated bacterial infections, and people suffer eye pain for years before they can potentially go blind from the disease. […] The bacteria infect the conjunctiva the thin, pink, soft inner layer of the eyelids which leads to inflammation. […] If people have many repeated infections, the inflammation scars the eyelids, which begin to turn inwards. The eyelashes then turn inwards and scratch the cornea (the clear surface of the eyes). In severe cases, this causes the cornea to become clouded, which eventually results in permanent blindness. […] Trachoma is a very painful disease. Aside from the risk of blindness, it causes blurry vision, red and swollen eyes, pain while blinking or sleeping, and vision loss.

• #1 Trachoma: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/25148-trachoma

  Trachoma that isnt treated, or trachoma that happens repeatedly, can develop into trachomatous trichiasis. […] If trachoma isnt treated, you wont be able to reverse the blindness that occurs. […] Your outlook is good if you have one episode of trachoma and take antibiotics. The complications start when youve had repeated episodes of the condition and your corneas are affected. […] But blindness caused by trachoma cant be cured.

• #1 Trachoma | Doctor

  https://patient.info/doctor/trachoma.htm

  Trachoma blindness results from corneal opacification, which occurs because of the mechanical trauma caused by entropion/trichiasis. […] Appropriate treatment of early disease gives an excellent prognosis. Severe disease may be stabilised but vision may not improve. Each re-infection worsens the prognosis.

• #1 Trachoma: Symptoms, Causes, Treatment, Cost, and Side Effects

  https://www.lybrate.com/topic/trachoma

  Antibiotics are effective in treating trachoma in its early state. But with passing time the condition could deteriorate and might require a surgical intervention to treat the condition. […] The infection could recur within a few weeks of starting treatment. […] Trachoma can be a serious illness if not treated on time and may turn the patient blind. […] Timely treatment is very crucial and has shown immediate benefit in eliminating trachoma and preserving peoples eye vision. […] Trachoma is one of the major causes for blindness or visual impairment in under-developed and developing countries around the world. […] After years of recurrent infection and scarring of the cornea, it can result in blindness that is irreversible. […] This, however, could be managed in early stages by taking a complete course of recommended antibiotics or if the infection advances a surgery may be needed to save the eyesight. […] The recurrence rate of trachoma is unfortunately very high and likely even after surgery.

• #2 Trachoma – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK559035/

  Trachoma is a debilitating eye disease caused by the Chlamydia trachomatis bacterium and is one of the leading causes of blindness worldwide. Trachoma predominantly affects the conjunctiva, and the infection results in inflammation, roughening, and scarring of the inner surface of the eyelids, along with erosion of the corneal surface. […] If the condition is left untreated, ocular complications can progress to blindness. […] Trachoma manifests in 2 distinct stages, each presenting unique symptoms and complications. First-phase symptoms: These symptoms include persistent keratoconjunctivitis characterized by inflammation of the conjunctiva, known as active trachoma. […] Second-phase symptoms: The progression to the second stage of the illness is marked by periods of intense conjunctival inflammation, leading to eyelid scarring. Trichiasis is a disorder in which the eyelashes rotate inward and come in touch with the eyeball due to scarring. […] Inverted eyelashes that scratch the cornea increase the risk of corneal opacity and visual problems, leading to blindness in severe chronic conditions.

• #2 Trachoma: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/25148-trachoma

  Trachoma is an eye disease caused by a bacterium called Chlamydia trachomatis. The infection can cause irreversible blindness. […] Signs and symptoms of early stages of trachoma include: Red and irritated eyes. Swollen eyelids. Blurred vision. Watery discharge from the eyes. Discharge from the nose. […] Advanced trachoma, or trachomatous trichiasis, happens after you have repeated infections and bouts of inflammation. The inflammation causes scar tissue on the inside of your eyelids and misdirection of your eyelashes, both of which scrape against your cornea. […] Signs and symptoms of advanced trachoma include: Tightened eyelids due to scar tissue. Inward-turning eyelashes because of the tight eyelids. Extreme eye pain caused by eyelashes scraping against your cornea. Light intolerance. Impaired vision, possible blindness.

• #2 Trachoma | NT.GOV.AU

  https://nt.gov.au/wellbeing/health-conditions-treatments/bacterial/trachoma

  It is important to note that active trachoma in children often causes no symptoms. […] Trachoma can be present even in children with clean faces. However, children with active trachoma may have red, sore, sticky eyes and nasal discharge. […] Follicles and inflammation under the upper eyelids are the hallmarks of active trachoma. […] As trachoma progresses, scarring develops under the eyelids. The eyelashes turn in and rub on the cornea. This abnormal condition is called trichiasis. This may be painful and will cause corneal scarring, followed by visual loss and then blindness. […] The cycle of repeated active infection and resolution occurs over many years. Teenagers and adults have the scarring stage of trachoma. Without treatment, adults may develop trichiasis which can ultimately lead to blindness.

• #2 Trachoma | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/trachoma-16689733.html

  Stage 1: trachomatous inflammation – follicular (TF) Presence of five or more follicles in the upper tarsal conjunctiva. Follicles are whitish, grey or yellow elevations, paler than the surrounding conjunctiva. […] Stage 2: trachomatous inflammation – intense (TI) The upper tarsal conjunctiva is red, rough and thickened. The blood vessels, normally visible, are masked by a diffuse inflammatory infiltration or follicles. […] Stage 3: trachomatous scarring (TS) Follicles disappear, leaving scars: scars are white lines, bands or patches in the tarsal conjunctiva. […] Stage 4: trachomatous trichiasis (TT) Due to multiple scars the margin of the eyelid, usually the upper lid, turns inwards (entropion); the eyelashes rub against the cornea and cause ulcerations and chronic inflammation. […] Stage 5: corneal opacity (CO) Cornea gradually loses its transparency, leading to visual impairment and blindness.

• #2 Trachoma | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/trachoma?content_id=CON-20378488

  At first, trachoma may cause mild itching and irritation of your eyes and eyelids. Then you may notice swollen eyelids and pus draining from the eyes. Untreated trachoma can lead to blindness. […] Signs and symptoms of trachoma usually affect both eyes and may include: Mild itching and irritation of the eyes and eyelids, Eye discharge containing mucus or pus, Eyelid swelling, Light sensitivity (photophobia), Eye pain, Eye redness, Vision loss. […] Young children are particularly susceptible to infection. But the disease progresses slowly, and the more painful symptoms may not emerge until adulthood. […] The World Health Organization (WHO) has identified five stages in the development of trachoma: Inflammation follicular, Inflammation intense, Eyelid scarring, In-turned eyelashes (trichiasis), Corneal clouding (opacity). […] All the signs of trachoma are more severe in your upper lid than in your lower lid. Without intervention, a disease process that begins in childhood can continue to advance into adulthood.

• #2 Trachoma – EyeWiki

  https://eyewiki.org/Trachoma

  Trachoma is the most common infectious cause of blindness in the world caused by recurrent ocular surface infections and secondary scarring of the ocular surface by the bacterial organism Chlamydia trachomatis. […] Most individuals are asymptomatic or have mild protean symptoms depending on the level of inflammation. Symptoms, if present, are similar to those seen in any chronic conjunctivitis and include chronic redness, discomfort, tearing, photophobia and mucopurulent discharge and visual loss in the late stages. […] Blindness from trachoma is due to recurrent episodes of active infection over months to years. The initial infection is confined to the conjunctival epithelium and triggers an immune response presenting as conjunctival follicles. Repeated infections with subsequent inflammatory responses results in tissue destruction with fibrosis and contraction, cicatricial entropion with trichiasis and lash corneal touch resulting in corneal erosions, ulcerations, scarring and vascularisation resulting in corneal opacification and resultant blindness.

• #2 Trachoma | Doctor

  https://patient.info/doctor/trachoma.htm

  Trachoma is a very common chronic conjunctival infection caused by Chlamydia trachomatis, which is transmitted by flies or through close personal contact. […] Repeated episodes of infection cause chronic follicular conjunctival inflammation (active trachoma), leading on to the cicatricial stage of tarsal conjunctival scarring, entropion, trichiasis (in-turning of the eyelashes) which leads to corneal scarring and opacity. […] Irreversible opacities result in visual impairment or blindness. The age at which this occurs depends on several factors including local transmission intensity. In very highly endemic communities it can occur in childhood, though onset of visual impairment between the ages of 30 and 40 years is more typical. […] With repeated episodes of infection over many years, the eyelashes may be drawn in so that they rub on the surface of the eye. This causes pain and may permanently damage the cornea.

• #2 Risk factors for the progression of trachomatous scarring in a cohort of women in a trachoma low endemic district in Tanzania | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0009914

  Trachoma, a chronic conjunctivitis caused by Chlamydia trachomatis, is the leading infectious cause of blindness worldwide. […] The rate of development of trachomatous trichiasis, the potentially blinding late-stage trachoma sequelae, depends on the rate of trachomatous scarring development and progression. […] The overall cumulative 3.5-year progression rate of scarring was 35.3% (95% CI 31.6-39.1). […] The odds of TS progression increased with an increase in age in women younger than 50, (OR 1.03, 95% CI 1.01-1.05, p = 0.005) as well as an increase in the household poverty index (OR 1.29, 95% CI 1.13-1.48, p = 0.0002). […] The 3.5-year progression of scarring among women in Kongwa, a formerly hyperendemic now turned hypoendemic district in central Tanzania, was high despite a low active trachoma prevalence.

• #2 Risk factors for the progression of trachomatous scarring in a cohort of women in a trachoma low endemic district in Tanzania | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0009914

  Our findings suggest that once scarring has developed it continues to progress irrespective of the current trachoma environment. […] The cumulative progression rate of scarring increased steadily with age until age 50 (test for trend, p = 0.011). […] The age adjusted logistic regression predicting odds of TS progression, adjusted for baseline TS severity, showed a significant association of TS progression with older age in those younger than 50 years of age, an increased risk with an increase in household poverty index, and the presence of an indoor cooking fire.

• #2 Trachoma – MD Searchlight

  https://mdsearchlight.com/eye-health/trachoma/

  Trichiasis: This is when eyelashes grow in the wrong direction and rub on the surface of the eye. Over time, this repeated rubbing can cause corneal sores, ulcerations, and scarring. Without treatment, this can progress to cause cloudiness of the front of the eye and blindness. […] Entropion: This complication happens when the eyelid turns inward, causing eyelashes to scrape the surface of the eye. This can lead to discomfort, corneal sores, and risk of blindness if not treated. Entropion can occur because of advanced scarring and recurrent infections from trachoma. […] Corneal opacities: These occur due to prolonged inflammation and scarring of the cornea. This cloudiness of the cornea can cause reduced vision and possibly irreversible vision loss. […] Blindness: Trachoma can eventually lead to irreversible blindness if not treated or managed properly. This not only affects the individual but also has major socio-economic impact on their community.

• #2 Trachoma – Wikipedia

  https://en.wikipedia.org/wiki/Trachoma

  If not treated properly with oral antibiotics, the symptoms may escalate and cause blindness, which is the result of ulceration and consequent scarring of the cornea. Surgery may also be necessary to fix eyelid deformities. […] Without intervention, trachoma keeps families in a cycle of poverty, as the disease and its long-term effects are passed from one generation to the next.

• #2 Trachoma – The International Agency for the Prevention of Blindness

  https://www.iapb.org/learn/knowledge-hub/eye-conditions/trachoma/

  Trachoma results from bacterial infection of the conjunctiva by Chlamydia Trachomatis. Repeated infections of the conjunctivae with Chlamydia trachomatis can lead to trichiasis, corneal opacity and blindness. […] Trachoma is the worlds leading infectious cause of blindness and one of 20 neglected tropical diseases (NTDs) that collectively affect over one billion of the worlds poorest people. […] The World Health Organization estimates that 1.9 million people are blind or experience vision impairment due to trachoma and two million people require urgent surgery to treat trachomatous trichiasis. […] Over the last two decades, significant progress has been made towards the global elimination of trachoma as a public health problem. The World Health Organization Weekly Epidemiological Record, published in 2021, reported that the number of people at risk of trachoma has declined from 1.5 billion in 2002 to 136.2 million in 2021 a 91% reduction.

• #2

  https://www.aao.org/eye-health/diseases/what-is-trachoma

  Trachoma is an eye infection affecting both eyes. It is the worlds leading cause of infectious blindness. A bacterium called Chlamydia trachomatis causes trachoma. In its early stages, trachoma causes conjunctivitis (pink eye). Early symptoms begin to appear within five to 12 days of exposure to the bacterium. These symptoms can include: mild itching and irritation of the eyes and eyelids, and a discharge from the eyes. As the infection progresses, it causes eye pain and blurred vision. If the infection is untreated, scarring occurs inside the eyelid. This leads to the eyelashes turning inward toward the eye. This condition is called trichiasis. The eyelashes brush and scratch against the cornea, the clear, dome-shaped window at the front of the eye. This continual irritation turns the cornea cloudy. It can lead to the development of corneal ulcers and vision loss. Having one episode of trachoma rarely causes problems. Ophthalmologists think that repeated infections lead to the scarring and blinding complications. Generally, it takes years before trachoma can cause vision loss.

• #2 Trachoma Eye Causes, Stages, Types, Transmission & Diagnosis

  https://www.medicinenet.com/trachoma/article.htm

  Trachoma is a contagious bacterial infection that affects the surface of the eyes. Over time, scar tissue or ulcers can form that lead to blindness. […] The symptoms include irritation of the eyes with tearing, pain, light sensitivity, and vision loss. The signs include the presence of follicles, redness, scarring, and corneal opacity as described in the five stages listed above. […] Some individuals who have trachoma infection of the eyes will have it only once and scarring will not necessarily occur. However, reinfections are common, and over many years, the untreated disease can progress through the five stages of blindness.

• #2 Trachoma | Doctor

  https://patient.info/doctor/trachoma.htm

  Trachoma blindness results from corneal opacification, which occurs because of the mechanical trauma caused by entropion/trichiasis. […] Appropriate treatment of early disease gives an excellent prognosis. Severe disease may be stabilised but vision may not improve. Each re-infection worsens the prognosis.

• #2 Trachoma: Background, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/1202088-overview

  Trachoma is the worlds leading infectious cause of blindness. This disease causes a chronic keratoconjunctivitis resulting from the obligate intracellular bacterium Chlamydia trachomatis. […] Repeated episodes of reinfection within the family cause chronic follicular or intense conjunctival inflammation (active trachoma), which leads to tarsal conjunctival scarring. The scarring distorts the upper tarsal plate and, in some individuals, leads to entropion and trichiasis (cicatricial trachoma). The end result includes corneal abrasions, corneal scarring and opacification, and, ultimately, blindness. […] The prognosis depends on the severity of the disease at the time of treatment, the appropriateness of the treatment, and the risk of reinfection. Patients in whom early disease is treated appropriately have an excellent prognosis. Reinfection worsens the prognosis. Severe disease may be stabilized, but the patient’s vision may not improve once corneal scarring has developed unless surgical options are available.

• #2 Blinding Trachoma: systematic review of rates and risk factors for progressive disease | LCNTDR

  https://www.londonntd.org/publications/blinding-trachoma-systematic-review-of-rates-and-risk-factors-for-progressive-disease

  Sight loss from trachoma is the end result of a scarring disease process starting in early childhood and characterised by repeated episodes of conjunctival inflammation (active trachoma). […] Subsequently, the conjunctiva becomes scarred, causing the eyelashes to turn inwards and scratch the cornea (trichiasis), damaging the corneal surface and leading to corneal opacification and visual impairment. […] Severe conjunctival inflammation was consistently associated with incident and progressive scarring in five studies in which this was examined. […] Intense conjunctival inflammation was consistently associated with scarring, however, direct evidence demonstrating an association between C. trachomatis and progression is limited. […] This suggests that on-going chlamydial reinfection may not be mandatory for progression of established scarring, indicating that sight threatening trichiasis may continue to evolve in older people in formerly endemic populations, that will require service provision for years after active disease is controlled.

• #3 Trachoma – including symptoms, treatment and prevention | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/conditions/infectious+diseases/trachoma/trachoma+-+including+symptoms%2C+treatment+and+prevention

  Trachoma is a preventable disease of the eyes caused by infection with the bacteria Chlamydia trachomatis (different from the sexually transmitted form of this germ). It causes loss of vision and blindness in older people who have had severe active trachoma, usually since childhood. […] Active trachoma in children often causes no symptoms. Trachoma can be present even in children with clean faces. However, children with active trachoma may have red, sore, sticky eyes and discharge from the nose. […] The cycle of repeated active infection and resolution occurs over many years. As trachoma progresses in teenagers and young adults, scarring develops under the eyelids. Without treatment the eyelashes turn in and rub on the cornea (the clear part of the front of the eye). This is called trichiasis, and may be painful. Eventually this will cause scarring of the cornea, followed by loss of vision and blindness.

• #3 Trachoma | MSF Medical Guidelines

  https://medicalguidelines.msf.org/en/viewport/CG/english/trachoma-16689733.html

  Stage 1: trachomatous inflammation – follicular (TF) Presence of five or more follicles in the upper tarsal conjunctiva. Follicles are whitish, grey or yellow elevations, paler than the surrounding conjunctiva. […] Stage 2: trachomatous inflammation – intense (TI) The upper tarsal conjunctiva is red, rough and thickened. The blood vessels, normally visible, are masked by a diffuse inflammatory infiltration or follicles. […] Stage 3: trachomatous scarring (TS) Follicles disappear, leaving scars: scars are white lines, bands or patches in the tarsal conjunctiva. […] Stage 4: trachomatous trichiasis (TT) Due to multiple scars the margin of the eyelid, usually the upper lid, turns inwards (entropion); the eyelashes rub against the cornea and cause ulcerations and chronic inflammation. […] Stage 5: corneal opacity (CO) Cornea gradually loses its transparency, leading to visual impairment and blindness.

• #3 Risk factors for the progression of trachomatous scarring in a cohort of women in a trachoma low endemic district in Tanzania

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8604323/

  The age adjusted logistic regression predicting odds of TS progression, adjusted for baseline TS severity, showed a significant association of TS progression with older age in those younger than 50 years of age, an increased risk with an increase in household poverty index, and the presence of an indoor cooking fire. […] The current rate of scarring progression in Kongwa is very similar to what we observed a decade prior in a Kongwa village where the prevalence of TF was 29%; we found a scarring progression rate of 47.5% (95% CI 31.5, 63.9) over 5 years or approximately 9.5% per year.

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