Trachoma (granular conjunctivitis): symptoms, diagnosis, and treatment by an ophthalmologist
Trachoma is a chronic eye infection. The disease begins as inflammation of the conjunctiva. With repeated or prolonged infections, it can lead to scarring, eyelid deformation, and corneal damage.
In the early stages, symptoms resemble those of common conjunctivitis. People experience redness, tearing, and a gritty sensation in the eyes. The danger of this disease is that without proper diagnosis, the inflammation can progress to complications.
At "K+31," we assess the stage of the disease, confirm the cause, and select treatment from an ophthalmologist without self-medication with antibiotics.
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The source of infection is associated with transmission of the pathogen through close contact. Infection also often occurs due to poor hygiene. The risk is higher when sharing towels, touching the eyes with contaminated hands, or coming into contact with eye secretions. The risk is also high in settings where eye infections can be transmitted within a family or group. The doctor will determine the contacts, duration of complaints, recurrence of inflammation, and previous treatment.
Prevention is based on simple measures, but it is important to follow them consistently:
- Avoid sharing towels and eye makeup
- Wash your hands before touching your face and eyelids
- Avoid rubbing your eyes if they are itchy or irritated
- Consult a doctor if eye inflammation recurs
- Do not start antibiotics without confirming the diagnosis
These rules reduce the risk of infection transmission, but do not replace an examination if symptoms have already appeared.
Trachoma Symptoms: What to Look Out For
Clinical manifestations depend on the stage. Initially, the patient may dismiss the condition as a simple irritation because the complaints are similar: redness, discomfort, discharge, and lacrimation. As the condition progresses, signs appear that indicate deeper and more prolonged inflammation.
Early Signs
In the early stages, symptoms include redness, a feeling of dryness or grit, moderate discharge, itching, and lacrimation. The conjunctiva appears irritated, and the patient experiences discomfort when looking at bright light. These signs make it difficult to differentiate trachoma from other types of conjunctivitis.
Signs of Active Inflammation
In active inflammation, the doctor may see follicles, thickening of the conjunctiva, severe inflammation of the eyes, and eyelid reactivity. The patient complains of photophobia, a gritty sensation in the eyes, and discomfort when blinking. Trachoma diagnosis is essential at this stage to avoid missing the transition to scarring.
When scars and complications appear
With prolonged scarring, the inner surface of the eyelids changes. Eyelashes can curl toward the cornea, damaging it with each blink. Pannus and corneal opacity increase the risk of vision loss, so complications require separate evaluation and sometimes surgical correction.
You should see a doctor if you experience the following symptoms:
- Eye inflammation recurs or lasts longer than usual
- Photophobia, tearing, and a gritty sensation are present
- Discharge, pain, or severe redness develops
- Vision has become less clear
- Eyelashes irritate the eye or scratch the cornea
If inflammation and vision loss occur simultaneously, it is best to see your doctor immediately.
How does a doctor confirm a diagnosis?
Trachoma should not be diagnosed based on a single description of symptoms. An ophthalmologist evaluates the eyelids, conjunctiva, cornea, the nature of the inflammation, and signs of scarring. If necessary, additional tests are ordered to confirm the infectious nature of the process and rule out similar conditions.
Eye and Eyelid Examination
During the appointment, the doctor evaluates the inner surface of the eyelids, the conjunctiva, and the presence of follicles, scars, and signs of corneal trauma. The doctor checks for inversion of the eyelids, abnormal eyelash growth, pannus, or cloudiness. This information is important for choosing the appropriate treatment.
Additional Diagnostic Methods
Laboratory tests, ocular surface staining, biomicroscopy, and visual acuity assessment may be used as indicated. Diagnosis of trachoma should answer two questions: is there an active infection and how severe are the consequences for ocular tissues. Treatment and follow-up plan depend on these factors.
How is an examination performed if trachoma is suspected:
- Collecting complaints, anamnesis, and contact information
- Examination of the eyelids, conjunctiva, and cornea under magnification
- Assessment of signs of active inflammation and scarring
- Additional confirmation of the diagnosis as indicated
- Prescribing therapy and a follow-up visit
This route helps avoid confusing granular conjunctivitis with another inflammatory disease.
General information
Trachoma Treatment
Treatment depends on the stage and activity of the inflammation, the condition of the cornea, and the presence of scars. A doctor may prescribe antibacterial therapy, but antibiotics are selected only after an examination and confirmation of the indications. Self-medication increases the risk of incomplete infection control and complications.
Drug Therapy
In active infections, medications targeting the pathogen and agents to control inflammation are used as indicated. We do not prescribe a one-size-fits-all regimen without an examination because age, comorbidities, the severity of the process, and drug tolerance are all important factors. Monitoring helps ensure that the inflammation is subsiding.
When is surgical correction necessary?
If scarring has resulted in eyelid deformity, inversion of the eyelashes, or persistent corneal trauma, surgical correction may be necessary. Surgery is discussed after assessing the tissue and vision risks. The goal is to protect the cornea from further damage and reduce the likelihood of complications.
Post-Treatment Monitoring and Observation
Even after inflammation subsides, the patient requires follow-up. The doctor evaluates the conjunctiva, corneal condition, scar severity, and any complaints. If inflammation recurs, it is important to seek early treatment to prevent further tissue damage.
Frequently Asked Questions
Short answers do not replace diagnosis, but they can help you understand why trachoma requires the attention of an ophthalmologist.
What is trachoma in simple terms?
Is trachoma contagious?
Can trachoma be completely cured?
When should you urgently see an ophthalmologist?
References
- WHO - Trachoma: https://www.who.int/ru/news-room/fact-sheets/detail/trachoma
- MSD Manuals - Trachoma: https://www.msdmanuals.com/ru/home/eye-disorders/conjunctival-and-corneal-disorders/trachoma
- Register of clinical recommendations of the Ministry of Health of the Russian Federation: https://cr.minzdrav.gov.ru/
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What is trachoma and why is it dangerous?
Ocular trachoma is associated with chlamydial infection. The infection affects the conjunctiva. With active inflammation, the following may appear:
If the process is repeated or prolonged, scarring may develop: the eyelid may become deformed, eyelashes may begin to injure the cornea, and pannus may impair tissue transparency.