March 2025 Newsletter: Trachoma

What Is Trachoma?

Trachoma is a serious eye infection caused by a type of bacteria called Chlamydia trachomatis. It usually starts off like a mild case of pink eye, itchy, irritated, maybe a little red, but if someone keeps getting reinfected, it can do real damage. Over time, the inside of the eyelid scars, and eventually the eyelashes can start turning inward. This painful condition is called trichiasis, and when those lashes scratch the surface of the eye, it can lead to cloudiness in the cornea and even permanent blindness.

The 5 Stages of Trachoma

Trachoma doesn’t happen all at once — it develops slowly, and it’s broken down into five stages:

1. Follicular Inflammation – little bumps form on the inside of the eyelid.

2. Intense Inflammation – the eyelid gets swollen and thicker.

3. Lid Scarring – scarring starts to build up inside the lid.

4. Trichiasis – lashes start to grow the wrong way, toward the eye.

5. Corneal Opacity – the cornea becomes cloudy, making it hard to see.

   
   

Where Is It Found?

Trachoma is most common in remote, poor areas where clean water and basic healthcare are hard to come by. It’s especially a problem in:

• Sub-Saharan Africa

• Some parts of Asia and Latin America

• The Middle East

• Indigenous communities in Australia

  
  

The World Health Organization says around 1.9 million people today are visually impaired because of trachoma.

How Does It Spread?

It spreads pretty easily. The bacteria get passed around through direct contact — like touching eye or nose discharge — or by sharing things like towels or washcloths. Flies can even carry it after landing on infected eyes. Kids tend to carry and spread it the most.

Because of that, places where hygiene is poor and people live close together see the most cases.

Symptoms to Look Out For

In the early stages, it feels like a regular eye infection:

• Itchy or irritated eyes

• Redness

• Light sensitivity

• Tearing or discharge

Later on, it gets worse:

• Pain

• Blurry vision

• Scarring inside the lid

• And in some cases, total blindness

  
  

Getting Diagnosed and Treated

Most of the time, an eye doctor can spot it just by looking. Sometimes, they’ll use lab tests to confirm the infection. Treatment depends on how far it’s progressed.

• Antibiotics: One dose of azithromycin can usually treat the infection.

• Surgery: If the lashes are already turning inward, a simple surgery can help protect the cornea.

• Cleanliness: Keeping faces clean is crucial to stop the cycle of reinfection.

  
  

The SAFE Strategy

The World Health Organization backs a global plan called SAFE to fight trachoma:

• Surgery for people with trichiasis

• Antibiotics to treat the infection

• Facial cleanliness to stop the spread

• Environmental improvements, like clean water and sanitation

This approach has already helped several countries—like Morocco and Mexico—eliminate trachoma as a public health problem.

Trachoma isn’t just an eye problem—it’s a problem rooted in poverty, lack of clean water, and poor access to care. The good news? It’s preventable, treatable, and with the right tools and awareness, we can beat it. It just takes education, clean environments, and the will to act.