What is Trachoma?

Trachoma is a bacterial eye infection, not unlike the common ‘pink-eye’ or conjunctivitis. It is caused by the bacterium Chlamydia trachomatis. Repeated reinfection, combined with the body’s immune reaction, often has devastating consequences.

Trachoma starts as an infection of the membrane that covers the outside of the eyeball and lines the inner surface of the eyelids (conjunctiva). Repeated infections can, over years, lead to scarring that causes the eyelid to turn inwards.

As the eyelid turns inwards, the eyelashes become inverted, eventually growing inwards. This is known as trichiasis. 

During trichiasis, the ingrown eyelashes rub on the clear cornea, painfully scratching it and causing damage. This eventually results in opaque, scarred corneas and distressingly uncomfortable eyes.

In a desperate attempt to reduce the pain caused by trichiasis, many people resort to pulling out their eyelashes with crude, makeshift tweezers.

Both eyes are usually affected and the scarring often leads to irreversible blindness.  

Who suffers from trachoma?

Trachoma used to be known as ‘sandy blight’, and has for centuries been associated with dry dusty conditions. It remains a disease of poverty and disadvantage, occurring in pockets where living conditions are crowded, water is scarce, and sanitation is inadequate.

 

Trachoma spreads from person to person through unwashed hands, shared face-wiping cloths, and by flies that have been in contact with the discharge from the eyes or nose of an infected person. Ongoing infection and re-infection fuels the progression of the disease to the stage where vision is lost.

 

Women suffer much more frequently and severely from trachoma than men. This is because women are usually the carers of young children, and end up being exposed to re-infections from infected children. This is tragic because if left untreated, the infection persists and the scarring worsens over years until it’s too late, and blindness is irreversible.

 

Blindness usually occurs when a person is between 30 and 40 years old. But in some parts of Oromia in Ethiopia, even children and young adults have significant trichiasis, putting them at risk of vision loss.

 

Where is trachoma found?

80% of people suffering from trachoma live in just 14 high-risk countries, 13 of which are in Africa (Pakistan is the other). Ethiopia has the world’s highest burden of trachoma.

 

Trachoma is most prevalent in communities with poor access to water and sanitation. And there are 42 countries known to need interventions for trachoma.

 

Australia is the only developed country in the world where trachoma is endemic. In Australia, trachoma remains endemic in a relatively small number of remote Aboriginal communities in the Northern Territory, South Australia and Western Australia. 

 

How is trachoma treated?

How can we eliminate trachoma?

The key to preventing trachoma is to help communities to overcome poverty.

 

Trachoma generally disappears as poverty levels decrease and the intense cycle of infection and re-infection is broken. Better access to antibiotics, health services, water and sanitation, early corrective surgery and monitoring of scarring are key to eliminating trachoma as a public health problem in endemic communities. Measures such as education about the disease, hygiene and face washing also help greatly.

 

In 2018, The Foundation ensured the delivery of antibiotics for trachoma to over 24.7 million people. And we’ve been making great progress with our partners to completely eliminate it from Ethiopia – where the disease has been endemic for generations. Not only have we been training thousands of community-based workers, but our surgical teams have been working from village to village operating on the most advanced cases.

 

There’s still much to do, but we’re dedicated to eradicating this disease all over the world.

How is The Fred Hollows Foundation helping people with trachoma? 

We are committed to the global elimination of trachoma as a public health problem. Through the efforts of a global coalition, we believe trachoma will be eliminated by the end of this decade.  

 

As women are four times more likely to need surgery for the blinding stages of trachoma, we strive to ensure our programming strategies and advocacy messages prioritise reaching women.

We subscribe to the programming priorities of the the World Health Organization Global Elimination of Trachoma 2020 (GET2020) and are a leading implementer of trachoma elimination initiatives globally.

 

Our Targets

Our 2019 - 2023 strategy sets out three key targets:

• Eliminate trachoma and ensure effective post-validation surveillance and response systems are in place in at least seven countries.

• Clear the trichiasis backlog and complete effective and safe MDA activities in the districts where we work in five countries.

• Work with the global community to strengthen and expand implementation of SAFE strategy across the trachoma-endemic districts until travjhoma is eliminated as a public health problem globally.

 

Find out about other eye conditions.

(DISCLAIMER: The content on this page is not intended to be medical advice. For specific medical advice, please contact your health professional.)