What Is Trachoma?

Trachoma is one of the bacterial infections of the eye. This disease is a contagious disease and is the highest cause of blindness in the world with most cases in Africa. Active trachoma is usually more common in children aged 3-5 years. While at adult age, adult women have a greater risk due to the frequency of closeness more often than men, such as caregivers.

Trachoma usually attacks the eyes and eyelids first with the initial symptoms of irritation and mild itching. Trachoma is transmitted by contact with the patient by holding objects exposed to bacteria, such as touching a used handkerchief covering a cough. Transmission can also come from the throat fluid that comes out. If not treated promptly, trachoma can cause serious complications until blindness.

Causes of Trachoma
Trachoma is an infection caused by Chlamydia trachomatis bacteria. These bacteria can also cause chlamydia (chlamydial) sexually transmitted diseases and are transmitted from someone who has been infected with this bacteria. Trachoma can be contagious when an infected person touches their eyes or nose and touches another person. Transmission of trachoma may also occur through intermediate objects, insects, or flies that alight in the eye. Flies can carry liquids containing bacteria from the eyes and nose to others. Objects such as towels and clothing can also be a medium of trachoma transmission.
The trachoma-causing bacteria cause inflammation of the inner lining of the eyelid and cause infection. Recurrent infections then cause the eyelid to be folded into. The growth of eyelashes grows inward to the eye. Severe and repeated infections can cause scarring of the cornea. The eye will then release mucus or pus containing bacteria that can be carried or infected to others.

Several other factors also play a role in the transmission of trachoma, namely:

• Populations living in poverty and overcrowded or coincident places, especially in poor countries.
• Poor sanitation has an impact on the low level of individual or human health, such as unclean hands and faces that facilitate the spread of the disease.
• A minimum number of toilets or inappropriate sanitary standards will increase the risk of contracting
• Uncontrolled population flies in an area will make the area vulnerable to various infections, including trachoma.
• The spread of trachoma will be higher if the related area has a high population of children as well, especially aged 4-6 years.
• Women have a higher risk of trakhoma than men. This can be due to the many activities associated with caring for or interacting with children.

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Symptoms of Trachoma
In addition to irritation and mild itching in the eyes and eyelids, trakhoma also has other symptoms, namely:

• Sore eyes
• Swelling of the eyes
• Sensitive to light
• Discharge of fluid or mucus from the eyes
• Increased heart rate
• Followed by complications in the ears, nose, and throat

Trachoma symptoms require a long process before eventually developing into a disease. Trachoma-causing bacteria have an incubation period of 5-12 days before a person develops an initial symptom of irritation or inflammation of the outermost layer of the eye and petals ( conjunctivitis ).
More painful symptoms generally also arise when the child has grown up. In addition, trachoma symptoms may also affect the tissue of the lubricating glands in the petals and tear producing glands (lacrimal gland) which causes the eyes to experience dryness which results in the more severe the condition of the trachoma earlier.

There are 5 stages of trachoma disease development according to the World Health Organization (WHO), namely:

• Inflammation of the follicle tissue containing lymphocytes, one type of white blood cell. This follicle can be seen on the inner surface of the upper eyelid.
• Inflammation (infection) becomes more severe and cause irritation and thickening or swelling of the upper eyelid.
• The scar tissue on the inside of the eyelid that appears will look like a thick white line, when viewed with a magnifying glass. This stage causes the eyelids to fold into or called entropion.
• Eyelash growth becomes influenced until it grows in (trikiasis) and swipes the cornea of ​​the eye as the outer surface of the eye.
• Corneas are constantly rubbed due to inflammation of the eyelid and eyelashes that grow in later will cause decreased quality of vision, which is to be vague ( corneal clouding ).

Immediately see a doctor if you experience any of the above symptoms or just return from traveling to areas prone to trachoma transmission. In addition to increasing the chances of healing and avoiding blindness, treating early trakhoma will also minimize the transmission of this disease to others.


Trachoma Diagnosis
Some things to consider before visiting a doctor related to the symptoms experienced are to stay home for a while to reduce the risk of disease transmission. Also avoid the following:

• Always make sure the cleanliness of the body
• Do not touch the eyes with unwashed hands,
• Sharing towels, handkerchiefs, or clothes with others. It is recommended to wash clothes every day and do not lend to others.
• Do not use contact lenses and eye-related cosmetics such as: mascara.
• If the patient is still a child, prevent children from being close to other children to avoid it

Patients will usually be referred directly to an ophthalmologist who will perform an examination on the eyelid or take samples of bacteria from the eyes for laboratory tests.


Trachoma Treatment
Trachoma can be treated with antibiotics and have a good healing rate if detected earlier. Treatment may differ if the patient is already at a more serious stage of trachoma development. Some types of trachoma treatment, namely:
The administration of drugs , usually done in the early stages of trachoma development using antibiotics. Drug azithromycin or tetracycline eye ointment are some examples of antibiotics that will be given by the doctor.

Eye surgical procedures are a possible step if the trachoma has been at a more severe stage, such as:

• Installation of adhesive bandages over feathersThe goal is not to touch the eyes. This procedure is temporary or if no eyelash removal procedure is available at the patient's location.
• Eyelash removalThis procedure can be done repeatedly to prevent the lashes from growing inward and injuring the cornea of ​​the eye.
• Eyelid rotation procedureThis procedure is done by making incisions on the wounded petals and keep the eyelashes from the cornea of ​​the eye. This procedure can also help prevent further corneal damage.
• Corneal transplantationThis procedure is performed if the trachoma has caused serious visual impairment due to scarring of the cornea. However, corneal transplantation due to trachoma is often not able to improve vision or do not have good results.

Trachoma infections are highly contagious and may occur repeatedly until treatment measures are usually performed on a larger and larger scale to stop the spread in areas with large trachoma cases.
WHO recommends an area with a child trachoma case that reaches above 10 percent of the total population to obtain trachoma treatment for all members of that population.


Trachoma Complications
Untreated trachoma infection or recurrent trachoma can lead to serious complications. Some complications that may occur, namely:

• Scarring on the inner surface of the eyelid.
• Changes in the shape of the eyelids. The eyelids may fold inward (entropion), or growing inner limbs (trichiasis).
• Scar tissue in the cornea of ​​the eye.
• Diminished partial or complete loss of vision.

Trachoma Prevention
Trachoma should be treated to prevent transmission or recurrence of infection. It is better that family members who live with the patient also perform eye examinations, and if necessary treatment, to ensure trakhoma does not harm others around him.
Start doing actions that lead to the creation of a clean and healthy environment for yourself and others around you. Thus you will also prevent the development and transmission of disease. Some actions that can be done, among others:

• Washing hands and face. Familiarize face and hand wash can remove bacterial fluid from the eyes and reduce the risk of transmission of infection. This is why clean water sources are also needed in populated areas.
• Reducing fly populations will also reduce the risk of spreading the disease. Managing waste or human or animal waste disposal is one way to reduce the breeding of flies.
• Adding and keeping clean and fresh water sources will help to keep the environment clean.

A strategy has been developed by the World Health Organization as part of the prevention of trakhoma through the SAFE method:

• Surgery as an effort to treat trakhoma at an advanced stage ( Surgery )
• Giving antibiotics to treat and prevent infection ( Antibiotics )
• Maintain facial hygiene ( Facial cleanliness )
• Increasing the feasibility of sanitation, water, and control of flies in the neighborhood ( Environmental improvements )

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