Egyptian ophthalmia -->
medical dictionary

<ophthalmology> A chronic infectious disease of the conjunctiva and cornea, producing photophobia, pain, lacrimation and blindness.

It is one of the oldest infectious diseases known to mankind, and dates back several thousand years with first documentation as early as the pharaonic era in Egypt.

The disease is associated with poor socioeconomic conditions in general: with overcrowding, poor personal and environmental hygiene and, in particular, with very limited access to water and sanitation. Trachoma has been eliminated as a blinding disease from several previously hyperendemic countries and regions, both through significant improvements in the socioeconomic status of populations and through specific control efforts.

Despite these successes, in many least developed countries of the world blinding trachoma continues to be an important public health problem. In some of the countries where trachoma was once hyperendemic, there remain residual pockets of blinding trachoma and complications, such as inturned eyelashes (trichiasis), which require eyelid surgery.

Today, the disease is found mainly in poor rural areas, including parts of central and south America, most African countries and some countries in the Eastern Mediterranean. Trachoma is still endemic in several Asian countries, but there is a lack of updated information from some major populations, e.g. In India and China.

The organism that causes this disease is Chlamydia trachomatis; a microorganism resembling both bacteria and viruses, which spreads through contact with eye discharge from the infected person (on towels, handkerchiefs, fingers, etc.) and through transmission by eye-seeking flies. Chlamydia trachomatis provokes an inflammatory reaction in the eye with formation of follicles in the conjunctiva. After years of repeated infections, the inside of the eyelids may be scarred so severely that the eyelid turns inwards with eyelashes rubbing on the eyeball. If untreated, this condition leads to blindness.

The World Health Organization is working towards global elimination of trachoma, which is responsible, at present, for at least 15% of the world's blindness. Worldwide, there are about 6 million people largely irreversibly blinded by trachoma, and an estimated 146 million cases of active disease in need of treatment, if blindness is to be prevented.

International efforts to eliminate trachoma as a blinding disease will be based on a combination of interventions known by the acronym "SAFE", which stands for Surgery for trichiasis (inturned eyelashes), Antibiotics, Facial cleanliness and Environmental improvement. These interventions will be community-targeted and will seek community involvement through the primary health care approach.

Origin: Gr. Trachoma = roughness

(07 May 1998)