Trachoma

Case history #1

A 5-year-old girl is brought by her grandmother into a remote clinic in Ethiopia, having been bitten by a dog. The physician notices that she has a very unclean face with significant nasal discharge. Eversion of the eyelids and examination of the superior tarsal conjunctiva, with the aid of a loupe and a torch, reveals the presence of numerous discrete white follicles.

Case history #2

A 50-year-old man comes into a remote clinic in the mountains of northern Vietnam for a routine health check. Eversion of the eyelids reveals trachomatous scarring, and an annual follow-up is arranged. Around 5 years later he returns for his review. On examination, several of his eyelashes are abrading his cornea. No opacity has developed on the cornea as yet.

Other presentations

Trachoma is confined to regions of disadvantage in Africa, the Middle East, Asia, Latin America, the Pacific Islands, and remote Aboriginal and Torres Strait Islander communities in Australia. Healthcare workers practising in non-endemic areas may occasionally need to consider the diagnosis of trachoma in an individual who has been living in, or has emigrated or is visiting from, a trachoma-endemic region.

Chlamydial conjunctivitis caused by the sexually transmitted strains of Chlamydia trachomatis (serotypes D to K) is a separate, self-limiting infection.