Are your eyes constantly red and itchy? Are there any watery discharges from your eyes? Maybe your eyelids are swollen and it's hard to see? These are not good signs. These could be early signs of an eye disease called trachoma, which we're going to talk about today. Don't worry, let's be clear about this. Because, like any disease, the sooner it's recognized, the easier it is to treat.
What is trachoma? Why is it dangerous?
Simply put, trachoma is a bacterial infection of our eyes. It is caused by a bacteria called Chlamydia trachomatis. If left untreated, it can gradually lead to vision loss and eventually irreversible blindness . Imagine how painful that is.
This disease is most common in poor, rural areas of the world. This means that the risk of this disease spreading is higher in environments where cleanliness is poor, clean water and sanitation are limited, and people live in very crowded conditions . Imagine, if many people live in the same small house, and if there is poor hygiene, how much more likely is it that a disease like this can be transmitted from one person to another.
According to the World Health Organization, in 2020 alone, about 32.8 million people were given antibiotics for trachoma. More than 42,000 people had to undergo surgery due to the disease. About 1.9 million people are blind or have impaired vision due to trachoma . This is a really sad situation, isn't it? The disease is most severe in the African continent. But trachoma is also found in countries like Asia, Australia, the Middle East, Central and South America.
What are the symptoms of trachoma?
There are some early signs of trachoma. Let's take a look at what they are:
- Eyes that are red and feel like they are just burning.
- Swelling of the eyelids.
- Not being able to see clearly, appearing blurry.
- A watery liquid (snot) flows from the eyes.
- Sometimes, a runny nose can also occur.
When you see these symptoms, some people may think, "Oh, this is just an eye infection." But this is not something to be dismissed as simple as that. Because, the problem only gets worse when this infection recurs and causes inflammation inside the eyes .
What happens when the disease worsens (Trachomatous trichiasis)?
Imagine, when the eye is continuously bothered by this bacteria, fine scars (scar tissue) begin to form inside the eye, that is, on the inside of the eyelid . Due to these scars, the eyelid shrinks inward, and the eyebrow on the eyelid turns inward . Now is the biggest problem. The eyebrow that turns inward like this, every time we blink , it rubs against the black ring of the eye, that is, the cornea .
The cornea is the transparent, curved "window" at the front of our eye. It helps us see clearly.
So, when the eyebrow keeps rubbing against the cornea like that, it gets scratched. It's like rubbing glass with sandpaper. Over time, the scratches cause the cornea to gradually thicken and become opaque, preventing light from passing through . That's when vision is lost.
In advanced trachoma, symptoms such as:
- The eyelids are pulled inward and tight due to the scar tissue.
- The eyebrow is turned inward.
- An unbearable eye pain caused by the eyebrow rubbing against the cornea.
- Inability to look at light (photosensitivity).
- Vision impairment, eventually blindness.
What causes trachoma? How is it transmitted?
As we mentioned earlier, trachoma is a bacterial infection. At first, it looks a bit like the common "eye disease" ``(Conjunctivitis)``. The eyes become red, itchy, and crusty. The best thing is that if you see a doctor early and take antibiotics, it can be completely cured .
This disease is spread through personal contact . That is, if the fluid (sputum, mucus) from the eyes or nose of an infected person gets on the hands, clothes, or bedding of others, it can be transmitted. Flies are also a major source of transmission . When flies land on the eyes or nose of an infected person, they pick up the germs and land on the eyes of another person. The disease is then transmitted.
Symptoms usually appear within 5 to 12 days after the germ enters the body. Women and young children are at higher risk of contracting this disease . This is because mothers are usually the ones who spend the most time with children and take care of them. Also, young children can easily get infected because they often touch their eyes and noses and do not care much about cleanliness.
How does a doctor diagnose trachoma?
If you have the symptoms mentioned above, you should definitely see an ophthalmologist. The doctor will ask you questions and take a medical history. In particular, they will ask if you have traveled to an area where trachoma is common or if you live in an environment where it is common.
Then an eye exam is done. Sometimes, the eye may be dilated and a small sample of the fluid from the eye may be taken and sent to a lab. This will help determine whether the infection is caused by the bacteria (Chlamydia trachomatis).
What are the treatments for trachoma?
This is the most important thing. In the early stages, it can be completely cured with antibiotics prescribed by the doctor . Two types of medication usually prescribed for trachoma are a pill called Azithromycin and an eye ointment containing Tetracycline.
However, if left untreated, or if trachoma occurs repeatedly, the previously mentioned serious condition, `(Trachomatous trichiasis)` (eyelash turning inwards), can occur. In that case, the doctor will suggest surgery . This surgery is done to make the inverted eyelash look straight again. Then the eyelash stops rubbing against the cornea, and further scarring stops.
However, if the cornea is severely damaged, the doctor may recommend a corneal transplant .
The most important thing to remember is that once you become blind from trachoma, it cannot be cured. That's why we say early detection and treatment are so important.
What happens if I get trachoma? Can it be cured?
If you get trachoma once and take antibiotics properly, you will recover quickly, there is nothing to worry about . The problem starts when this disease occurs repeatedly and the cornea starts to be damaged.
After the eyelid surgery, the cornea will stop getting damaged further. However, blindness caused by trachoma cannot be cured .
What should we do to reduce the incidence of trachoma?
This is the most important thing. To stop trachoma, it is essential to improve access to clean water and sanitation . That means everyone needs to have access to clean water and good sanitation. It is also important to reduce overcrowding and reduce the nuisance caused by flies. Authorities around the world are implementing these measures to try to eliminate trachoma and the blindness it causes. The acronym SAFE is used for this:
- S - `(Surgery)`: Surgery to cure an advanced disease.
- A - `(Antibiotics)`: Antibiotics for infections.
- F - `(Facial cleansing)`: Keeping the face clean to stop the spread of disease.
- E - `(Environmental changes)`: Environmental changes such as clean water and sanitation services.
In some areas, children between the ages of 1 and 9 are given antibiotics at least once a year. This is called "blanket therapy" or "blanket antibiotic therapy." However , there is concern that when antibiotics are given continuously in this way, bacteria can develop antibiotic resistance .
There are some things you can do on a personal level, especially if you live in or are traveling to an area where trachoma is prevalent:
- Take great care of your cleanliness . Wash your face thoroughly and remove any fluids from your eyes and nose.
- Wash your hands thoroughly and regularly . This is especially important when you are around young children.
- Do not share your used towels and bedding with others .
- Avoid places where there are flies as much as possible.
When should we see a doctor?
If you live in an area with trachoma, or have been to one, and you have discharge from your eyes or nose, be sure to see a doctor . Especially if you have eye pain, don't ignore it . It's best to tell a doctor about eye pain, or any symptoms you suspect.
What is the difference between chlamydial conjunctivitis and trachoma?
This is a question that many people ask. Chlamydial conjunctivitis is an eye infection caused by the sexually transmitted infection (STI) Chlamydia. The bacteria that causes it are the same as the bacteria that causes trachoma, Chlamydia trachomatis, but the subtypes of the germ are different . Importantly, trachoma is not a sexually transmitted infection .
If you live in an area where trachoma is common, or if you are traveling to one, it is important to take steps to prevent the spread of this disease. You can protect yourself by washing your hands well and keeping your face clean. If your eyes become red or itchy, be sure to see a doctor. They can prescribe antibiotics to treat the symptoms and the infection.
Important things to remember (Take-Home Message)
Okay, so we've talked a lot about trachoma today, haven't we? Finally, here are the most important things you need to remember:
- Trachoma is a serious eye disease caused by bacteria that can even lead to blindness.
- Cleanliness is the most important thing. Washing your hands well, keeping your face clean, and using clean water are very important.
- If you recognize the symptoms early and get treatment, you can completely cure it. So if you have symptoms like red, itchy, or crusty eyes, see a doctor right away.
- Beware of flies. Flies are the main ones that help spread this disease.
- If left untreated, the eyeball can turn inward, damaging the cornea and causing vision loss.
- The World Health Organization's SAFE approach (surgery, antibiotics, facial cleansing, environmental changes) is very important in controlling this disease.
So, if we take care of these points, we can protect ourselves from this silent enemy called trachoma. If you have any more questions about this, don't be afraid to ask a doctor. Two healthy eyes are a great value in life!
` Trachoma, eye diseases, eye infections, Chlamydia trachomatis, blindness, eye health, prevention
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