Trachoma Treatment
Dec 15, 2021
Source: Cainiu Health
Dr. Cui Xin
Introduction
Trachoma Treatment:
1. Pharmacological treatment: *Chlamydia trachomatis*, the causative agent of trachoma, is susceptible to tetracyclines, macrolides, and fluoroquinolones. In acute or severe trachoma, systemic antibiotic therapy is indicated—oral doxycycline or erythromycin may be administered.
2. Surgical treatment: Indicated for ocular complications such as severe entropion with trichiasis, suppurative lymphadenitis caused by lymphogranuloma venereum, and elephantiasis.
Trachoma is a specific type of conjunctivitis primarily caused by infection. It typically presents acutely, with symptoms such as photophobia and excessive tearing. After the acute phase subsides, the condition may progress to a chronic stage. While spontaneous improvement often occurs during the chronic phase, relapses are also possible. Moreover, trachoma is highly contagious; therefore, precautions should be taken to avoid transmission through direct contact. Currently, there are three main treatment approaches for trachoma.
Treatment of Trachoma
1. Pharmacological Treatment
Chlamydia trachomatis—the causative organism of trachoma—is susceptible to tetracyclines, macrolides, and fluoroquinolone antibiotics. Topical therapy includes instillation of 0.1% rifampicin or 15% sodium sulfacetamide eye drops; at night, tetracycline ointment or erythromycin ointment may be applied. In cases of acute or severe trachoma, systemic antibiotic therapy is recommended—oral doxycycline or erythromycin are commonly prescribed.
2. Surgical Treatment
Surgery is indicated for ocular complications, including severe trichiasis (in-turned eyelashes), suppurative lymphadenitis secondary to lymphogranuloma venereum, and elephantiasis.
Symptoms of Trachoma
1. Acute Trachoma
Acute trachoma manifests as acute follicular conjunctivitis, characterized by eyelid edema, marked conjunctival hyperemia, and papillary hypertrophy causing a rough, uneven tarsal conjunctiva. The upper and lower fornices are densely covered with follicles. Concurrent diffuse corneal epithelial inflammation and preauricular lymphadenopathy are common. Within several weeks, the disease typically transitions into the chronic phase.
2. Chronic Trachoma
Chronic trachoma may persist for years—or even over a decade—due to recurrent infections. Conjunctival hyperemia diminishes in severity, while papillary hypertrophy and follicle formation persist. Follicles vary in size and may appear gelatinous. Lesions are most prominent in the upper fornix and along the superior tarsal border; similar changes may also involve the inferior tarsal and inferior fornix conjunctiva, and in severe cases, may extend to the caruncle.
The choice of treatment for trachoma depends on its severity. For mild-to-moderate cases, pharmacological therapy is generally sufficient—eye drops should be administered four to six times daily. More severe cases may require systemic antibiotic therapy or surgical intervention.
