Trachoma, classed as a neglected tropical disease, is a contagious eye condition caused by infection with Chlamydia trachomatis. It is most prevalent in places where poor hygiene, overcrowding, and limited access to clean water increase risk of spread. Recurrent infections over years lead to chronic inflammation, scarring, and ultimately blindness if left untreated.
Trachoma often begins in childhood with mild symptoms, which can be overlooked. Initial infection may cause redness and irritation of the eyes and eyelids. There are five stages of the disease.
Common symptoms include:
The primary danger of trachoma is its potential to cause irreversible blindness. Chronic infection leads to scarring of the eyelid, turning it inward. This condition, known as trichiasis, results in eyelashes rubbing against the cornea, leading to corneal ulcers and clouding of the eye. It is an excruciatingly painful condition and sufferers sometimes resort to plucking out their eyelashes in a bid to relieve the pain.
The economic cost of trachoma and the resulting blindness and impaired vision is considerable – an estimated $10.9 to $13.3 billion every year.
Trachoma spreads through contact: hands, clothes, bedding and hard surfaces. It is also spread by flies that have been in contact with the discharge of an infected person. The disease is most common among children, while adults develop complications from repeated infections as children.
The antibiotic azithromycin is an effective treatment against the disease. Treatment focuses on eliminating the infection and preventing long-term damage. In cases where the eyelashes have begun to turn inward surgery can correct this. This is an effective procedure and was performed more than 80,000 times in 2024, according to the World Health Organization (WHO).
In 1993 WHO launched the SAFE strategy to prevent trachoma. This stands for
Trachoma is an ancient disease with hieroglyphs on ancient Nubian tombs in Sudan depicting eyes and tweezers. 1805 saw the opening of Moorfields Eye Hospital – now one of the major eye hospitals of the world – primarily to treat patients with the disease, which was then rife in the UK and the rest of Europe. In the 1930s a Chinese researcher, Tang Feifan, identified the bacterium that causes trachoma, paving the way for antibiotic treatment – it was wiped out in most high income countries by the mid 20th century. In 1993 azithromycin was first used to treat the disease and in 2012 Oman became the first country to be certified by the WHO to have eliminated trachoma. Since then 24 more countries have joined Oman.
cdc.gov/neglected-tropical-diseases/trachoma
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