Diagnosis

Your doctor can diagnose trachoma through a physical examination or by sending a sample of bacteria from your eyes to a laboratory for testing. But lab tests aren't always available in places where trachoma is common.

Treatment

Trachoma treatment options depend on the stage of the disease.

Medications

In the early stages of trachoma, treatment with antibiotics alone may be enough to eliminate the infection. Your doctor may prescribe tetracycline eye ointment or oral azithromycin (Zithromax). Azithromycin appears to be more effective than tetracycline, but it's more expensive.

The World Health Organization (WHO) recommends giving antibiotics to an entire community when more than 10 percent of children have been affected by trachoma. The goal of this guideline is to treat anyone who has been exposed to trachoma and reduce the spread of trachoma.

Surgery

Treatment of later stages of trachoma — including painful eyelid deformities — may require surgery. WHO guidelines recommend surgery for people with the advanced stage of trachoma.

In eyelid rotation surgery (bilamellar tarsal rotation), your doctor makes an incision in your scarred lid and rotates your eyelashes away from your cornea. The procedure limits the progression of corneal scarring and may help prevent further loss of vision.

If your cornea has become clouded enough to seriously impair your vision, corneal transplantation may be an option that may improve vision. Frequently, however, with trachoma, this procedure doesn't have good results.

You may have a procedure to remove eyelashes (epilation) in some cases. This procedure may need to be done repeatedly. Another temporary option, if surgery isn't an available option, is to place an adhesive bandage over your eyelashes to keep them from touching your eye.

Preparing for your appointment

You're likely to start by seeing your primary care doctor if you or your child has symptoms of trachoma. Or you may be referred immediately to an eye specialist (ophthalmologist). When you make the appointment, ask if you need to do anything to prepare for your appointment, such as keeping your child home from school or child care.

Here's some information to help you get ready for your appointment.

What you can do

Before your appointment make a list of:

  • Symptoms of the person seeking treatment, including any details about changes in vision
  • Key personal information, such as recent travel, use of new makeup products, and a change of contacts or glasses
  • All medications and any vitamins or supplements that the person seeking treatment is taking
  • Questions to ask your doctor

For eye irritation, some basic questions to ask your doctor include:

  • What's the most likely cause of these symptoms?
  • Other than the most likely cause, what are other possible causes for these symptoms?
  • What kinds of tests are needed?
  • Is the condition likely temporary or chronic?
  • What is the best course of action?
  • Will this condition cause any long-term complications?
  • Does my child or I need to follow and restrictions, such as staying home from work or school?
  • Should I see a specialist? What will that cost, and will my insurance cover it?
  • Is there a generic alternative to the medicine you're prescribing for me?
  • Do you have any brochures or other printed material for me? What websites do you recommend visiting?

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • Have you ever had a similar problem?
  • When did you first begin experiencing symptoms?
  • How severe are your symptoms? Do they seem to be getting worse?
  • What, if anything, seems to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
  • Is anyone else in your household having similar symptoms?
  • Have you been treating your symptoms with any medications or drops?

What you can do in the meantime

While you are waiting for your appointment, practice good hygiene to reduce the possibility of spreading your condition by taking these steps:

  • Don't touch your eyes without first washing your hands.
  • Wash your hands thoroughly and frequently.
  • Change your towel and washcloth daily, and don't share them with others.
  • Change your pillowcase often.
  • Discard eye cosmetics, particularly mascara.
  • Don't use anyone else's eye cosmetics or personal eye care items.
  • Discontinue wearing your contact lenses until your eyes have been evaluated; then follow your eye doctor's instructions on proper contact lens care.
  • If your child is infected, have him or her avoid close contact with other children.
Aug. 21, 2015
References
  1. Yanoff M, et al., eds. Conjunctivitis. In: Ophthalmology. 4th ed. Edinburgh, U.K.: Mosby Elsevier; 2014. https://www.clinicalkey.com. Accessed July 10, 2015.
  2. Wright HR, et al. Overview of trachoma. http://www.uptodate.com/home. Accessed July 10, 2015.
  3. Water-related diseases: Trachoma. World Health Organization. http://www.who.int/water_sanitation_health/diseases/trachoma/en/#. Accessed July 10, 2015.
  4. Trachoma. Merck Manual Professional Version. http://www.merckmanuals.com/professional/eye-disorders/conjunctival-and-scleral-disorders/trachoma. Accessed July 20, 2015.
  5. Guerrant RL, et al., eds. Trachoma. In: Tropical Infectious Diseases: Principles, Pathogens and Practice. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2011. https://www.clinicalkey.com. Accessed July 10, 2015.
  6. World Health Organization. WHO alliance for the global elimination of blinding trachoma by the year 2020. WER. 2014;39:421. http://www.who.int/wer. Accessed July 10, 2015.
  7. Preventing the spread of conjunctivitis. Centers for Disease Control and Prevention. http://www.cdc.gov/conjunctivitis/about/prevention.html. Accessed July 20, 2015.
  8. Hod E, et al. Face washing promotion for preventing active trachoma. Cochrane Database of Systematic Reviews. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003659.pub4/abstract. Accessed July 20, 2015.
  9. Taylor HR, et al. Trachoma. The Lancet. 2014;384:2142.