Trachoma a highly contagious chronic form of conjunctivitis affecting the eyelids caused by a strain of Chlamydia trachomatis. Hypertrophy of the conjunctiva, and formation of follicles with subsequent cicatrichal changes are noted in this disease. The disease is very harmful to the eyes and in the past it was the main cause of blindness throughout the world. It is estimated that the disease affects about 400 million people annually, mostly in tropical Africa and Asia, but is also seen in southwestern parts of America. About 20 million persons became blind by this disease. Although the incidence of the disease is greatly reduced during recent years, it has not been eradicated completely. Children under 15 years are susceptible, but elderly people are not spared.
People living in damp, slum areas of different cities of Bangladesh, and those living in unhygienic conditions in rural and thickly populated suburban areas are the victims. Complications include pannus, ptosis, and corneal ulcers. The eyelids become very swollen and inflamed and there is a discharge.
Children with ocular infections are the primary reservoir of the infection, and the spread is by hand-to-eye contact between children or on the feet of flies that feed on the exudates of the children with active infection. Transmission readily occurs not only by direct contact with trachomatous material, but also indirectly through contaminated articles such as towels, gamchha or handkerchiefs. In the slum areas where drainage does not exist, through dirty stagnant water where flies abound, the disease spread quite fast by the flies. Under such conditions entire family members may be infected within a day from one diseased person. Often the social workers of various NON GOVERNMENT ORGANISATIONs (NGOs) while visiting the slum areas become exposed to the disease.
Use of eye drops for the common conjunctivitis and eye inflammation may temporarily reduce the severity of trachoma. It is not however, ordinarily prescribed for the treatment of the disease. Topical application of tetracycline or erythromycin and systemic tetracycline or toxicycline is quite effective. Frequent flushing of eyes with cold water relieves some discomfort of the eyes. Personal hygiene, cleanliness and avoiding the use of materials of diseased persons are the best preventive methods. [SM Humayun Kabir]