Trachoma is a severe type of conjunctivitis (see under EYE, DISORDERS OF). This chronic contagious condition is caused by Chlamydia trachomatis, a bacterium with virus-like characteristics. The disease is endemic in 42 countries where 200 million people are at risk. It is the leading cause of blindness and visual impairment in the developing world, with 1.9 million being affected by 2015. The organism is transmitted by flies and causes inflammation of the conjunctiva and cornea (see EYE) with consequent scarring. The active disease is treated with tetracycline tablets and eye drops; cure is usually satisfactory. In theory, trachoma should be easy to eliminate. The World Health Organisation, which aims to do this by 2020, is using a four-pronged strategy (‘SAFE’)to tackle the disease. These are:
Surgery to correct deformed eyelids before blindness occurs.
Antibiotics to kill Chlamydia.
Face-washing to stop bacterial spread.
Environmental improvements – for example, better sanitation and rubbish disposal – to eliminate the bacteria.