title: Eradicating blinding trachoma: What is working?
abstract: Trachoma remains the leading cause of preventable corneal blindness in developing countries. The disease is contracted in early childhood by repeated infection of the ocular surface by C. trachomatis. Initial clinical manifestation is a follicular conjunctivitis which if not treated on timely basis, may lead to conjunctival and eyelid scarring that may eventually result in corneal scarring and loss of vision. Over the past two decades, a remarkable reduction in the prevalence of active trachoma has occurred due to the World Health Organization's (WHOs) program GET 2020 for the elimination of trachoma with adoption of the SAFE strategy incorporating Surgery, Antibiotic treatment, Facial cleanliness and Environmental hygiene. However, patients who already had infection at young age may present with adnexal-related complications of trachomatous scarring that may cause corneal scarring and visual loss. These patients may present with evidence of trichiasis/entropion as well as eyelid retraction. Lacrimal complications may include nasolacrimal-duct obstruction, dacryocystitis and canaliculitis requiring intervention. In addition to the increased risk for corneal scarring, trichiasis/entropion may further increase the risks for microbial keratitis in patients who may have unrecognized dacryocystitis and canaliculitis. Female patients may have more trachomtous-related complications and may present at an early age. Available evidence indicates that SAFE strategy may be effective and on the right track towards achieving GET 2020 goal for the eradication of trachoma.
authors: Oculoplastic and Orbit Division, King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh 11462, Saudi Arabia.
authors: Imtiaz A
authors: IA
authors: Chaudhry
keywords: Adnexal complications; Chlamydia trachomatis; Evaluation; Trachoma; Treatment; Visual loss
references: Int Ophthalmol. 1988;12(1):41-5
references: 3220667
references: Cochrane Database Syst Rev. 2006 Jul 19;(3):CD004008
references: 16856026
references: Am J Ophthalmol. 1969 Feb;67(2):235-43
references: 5764641
references: Am J Trop Med Hyg. 1960 Mar;9:116-24
references: 14425423
references: Int J Epidemiol. 1991 Dec;20(4):1088-92
references: 1800408
references: Int Ophthalmol. 1988;12(1):37-9
references: 3065266
references: Cornea. 2008 Feb;27(2):129-32
references: 18216564
references: Am J Ophthalmol. 1967 May;63(5):Suppl:1372-408
references: 5337745
references: Arch Ophthalmol. 1989 Aug;107(8):1180-2
references: 2757548
references: Rev Int Trach Pathol Ocul Trop Subtrop Sante Publique. 1997;74:97-106
references: 9889581
references: Ophthalmology. 1993 Sep;100(9):1293-6
references: 8371914
references: Am J Epidemiol. 1969 Oct;90(4):278-84
references: 5823441
references: Br J Ophthalmol. 1976 Apr;60(4):253-5
references: 776210
references: Br J Ophthalmol. 1943 Jul;27(7):308-10
references: 18169940
references: Br Med Bull. 2007;84:99-116
references: 18175788
references: J All India Ophthalmol Soc. 1964 Oct;12:107-13
references: 14213318
references: Orbit. 2004 Dec;23(4):227-36
references: 15590524
references: Ophthalmic Epidemiol. 1997 Sep;4(3):127-40
references: 9377281
references: East Mediterr Health J. 2004 Jan-Mar;10(1-2):192-7
references: 16201727
references: Am J Trop Med Hyg. 1966 Jul;15(4):639-47
references: 5941182
references: Eye (Lond). 2008 Jul;22(7):912-7
references: 17332761
references: Clin Exp Ophthalmol. 2008 May;36(4):348-52
references: 18700922
references: Bull World Health Organ. 2001;79(3):233-6
references: 11285668
references: Ophthalmology. 2009 Nov;116(11):2047-50
references: 19744717
references: JAMA. 1986 Jun 27;255(24):3378-84
references: 3712697
references: Br J Ophthalmol. 1980 Apr;64(4):296-8
references: 6992857
references: Braz J Med Biol Res. 2004 May;37(5):669-74
references: 15107928
references: Lancet. 1997 May 24;349(9064):1511-2
references: 9167460
references: Clin Exp Ophthalmol. 2005 Apr;33(2):142-6
references: 15807821
references: Ophthalmic Epidemiol. 2006 Feb;13(1):59-66
references: 16510348
references: Am J Trop Med Hyg. 2003 Nov;69(5 Suppl):18-23
references: 14692676
references: Br J Ophthalmol. 1996 Oct;80(10):880-9
references: 8976698
references: Ophthalmologe. 1993 Feb;90(1):17-20
references: 8443442
references: Am J Ophthalmol. 1988 Feb 15;105(2):203-6
references: 3277438
references: Infect Immun. 1970 Jul;2(1):65-8
references: 16557801
references: Klin Monbl Augenheilkd. 1981 Jun;178(6):464-8
references: 7021978
references: Am J Trop Med Hyg. 1969 Sep;18(5):723-30
references: 4897605
references: Br J Ophthalmol. 2006 Feb;90(2):171-4
references: 16424528
references: Bull Soc Belge Ophtalmol. 2001;(280):73-96
references: 11486468
references: J Ayub Med Coll Abbottabad. 2005 Jan-Mar;17(1):1-4
references: 15929516
references: Am J Trop Med Hyg. 1975 May;24(3):509-15
references: 1155691
references: Br J Ophthalmol. 1989 Jul;73(7):536-40
references: 2757994
references: Br J Ophthalmol. 2005 Sep;89(9):1084-8
references: 16113353
references: Ophthalmologica. 2004 May-Jun;218(3):214-8
references: 15103220
references: Ophthalmology. 1980 Apr;87(4):298-301
references: 7393535
references: J Chemother. 2001 Apr;13 Suppl 1:18-22
references: 11434524
references: Int Ophthalmol. 1988;12(1):9-14
references: 3065271
references: Eye (Lond). 2006 Mar;20(3):362-9
references: 15818386
references: Br J Ophthalmol. 2001 Jul;85(7):771-5
references: 11423445
references: Am J Trop Med Hyg. 1970 Sep;19(5):842-5
references: 4916640
references: Acta Ophthalmol (Copenh). 1991 Apr;69(2):200-4
references: 1872138
references: Ophthalmic Plast Reconstr Surg. 2007 Mar-Apr;23(2):169-70
references: 17413645
references: Ophthalmologica. 2000;214(4):277-84
references: 10859511