How is trachoma treated?

Trachoma is an eye disease caused by bacterial infection. It is typically treated with medications, including topical eye drops or ointments, follicular expression (squeezing), or surgical intervention.

How Is Trachoma Treated?

1. Topical Eye Drops

Sodium sulfacetamide eye drops are commonly used—1–3 drops per application, administered 3–4 times daily. At night, erythromycin or tetracycline ointment may be applied.

2. Topical Application or Follicular Expression

In cases of abundant follicles, a physician may use cuttlefish bone (sepia) or specialized follicle-expressing forceps to disrupt the follicles. This procedure is performed once weekly; clinical improvement is usually observed after 2–3 sessions. However, this method does not eradicate the infection, and concurrent pharmacologic therapy remains essential.

3. Pharmacologic Therapy

Chlamydia trachomatis—the causative agent of trachoma—is highly sensitive to antibiotics. Mild cases may be managed effectively with topical fluoroquinolone eye drops. In severe cases, systemic antibiotic therapy is required—typically oral administration—which yields excellent therapeutic outcomes. However, if clinical response is suboptimal, alternative antibiotics should be considered promptly. Patients should seek timely medical evaluation, including diagnostic testing using appropriate instrumentation, to ensure accurate diagnosis and targeted treatment.

4. Surgical Intervention

Trachoma can lead to serious ocular complications, including entropion (inward turning of the eyelid), trichiasis (misdirected eyelashes rubbing against the cornea), and, in advanced cases, lymphogranuloma venereum. Secondary complications such as suppurative lymphadenitis may also occur. When such complications develop, topical therapy alone is insufficient; prompt referral to an ophthalmologist is mandatory to prevent irreversible vision loss or other severe sequelae.

5. Systemic Therapy

During the acute phase or in severe trachoma, adults may receive systemic sulfonamides in addition to topical treatment. A typical course lasts 7–10 days, followed by a one-week drug-free interval before initiating the next course. Two to four courses may be required. Clinicians must monitor closely for potential adverse effects. Due to prolonged duration and high dosages, systemic antibiotics carry increased risk of side effects and are therefore rarely employed.

The above outlines key approaches to trachoma management. We hope this information proves helpful.