trachoma

The Columbia Encyclopedia, 6th ed.

trachoma

trachoma (trəkō´mə), infection of the mucous membrane of the eyelids caused by the bacterium Chlamydia trachomatis. Trachoma affects at least 86 million people worldwide. An estimated 1.9 million people are blind or visually impaired because of it, making the disease the second leading cause of blindness, after cataracts. It is most common in parts of Africa, the Middle East, and Asia, typically occurring in the poorest, most rural areas. In the United States it has occurred sporadically among Native Americans and in mountainous areas of the South.

Trachoma is highly contagious in its early stages and is transmitted by direct contact with infected persons or articles (e.g., towels, handkerchiefs) and also by flies. It begins as congestion and swelling of the eyelids with tearing and disturbance of vision. The cornea is often involved. If left untreated, scar tissue forms, which causes deformities of the eyelids and, if there is corneal involvement, partial or total blindness. The disease has been effectively treated with tetracycline ointment and with the newer oral drug azithromycin (Zithromax). The World Health Organization began a campaign in 1998 to eradicate the disease worldwide by the year 2020. The strategy includes use of azithromycin and sanitation improvements in water supplies. A number of countries have made significant progress against the disease, and some have eliminated it entirely.

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