How does trachoma lead to blindness?
When a person's eyes are infected with the bacteria that causes trachoma, the inner upper eyelid often becomes inflamed. Many active cases are mild and get better in a few weeks or months. Sometimes the infected person's body responds with a severe inflammatory reaction in which the eyes may become painful, a white watery discharge may be present, and sunlight can be unbearable.
The cycle of active infection and resolution over time leads to the development of scars on the lining of the lid. With more infections leading to more scarring, the scars slowly develop into a network. Over time, this network of scars contracts, shortening the inner lining of the eye. The shortening distorts the lid, pulling the lashes closer to the eye. Eventually the eyelashes touch the eye, causing damage. This condition is called trichiasis. Trichiasis soon becomes extremely painful as more lashes rub against the eyes. Smoke, dust, and sunlight make the discomfort even more unbearable, and sufferers prefer to stay indoors.
As the rubbing of the lashes scratches the globe of the eye, also known as the cornea, other infections develop. The combination of scratching and infection finally turns the cornea opaque, and vision is lost. Blindness or near blindness due to trachoma and trichiasis can only be restored by corneal transplant, which is nearly impossible to receive in developing nations.
Fortunately, there are solutions for those affected by trachoma. Surgery can reverse the in-turning of the lashes and sometimes prevent blindness, and antibiotics can be used to treat active trachoma. Additionally, incorporation of good hygiene practices and environmental improvements can greatly reduce the transmission of the disease.
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