How the disease develops
The first infection most often occurs in early childhood and manifests itself as prolonged conjunctivitis. Small light grains appear on the inner surface of the upper eyelid - accumulations of lymphoid tissue. If a person lives in conditions where infection is repeated again and again, the inflammation becomes chronic. Gradually, whitish scars form in place of the follicles, which tighten the tissue of the eyelid. The eyelid becomes deformed, its edge turns inward, and the eyelashes begin to touch the cornea with every blink. It is long-term re-infection, and not a single episode, that leads to serious consequences.
- The causative agent is chlamydia of certain types
- The first infection is usually in childhood
- Repeated infections play a key role
- Scarring of the conjunctiva of the eyelid
- Entropion and trichiasis
- Corneal opacity and advanced blindness
How it is transmitted and who is at risk
The infection spreads through direct contact with secretions from the eyes and nose of a sick person. The main routes are dirty hands, shared towels, pillowcases, scarves, as well as flies that carry the pathogen from face to face. The disease is closely related to living conditions: overcrowding, lack of clean water for washing, lack of toilets, and a large number of flies. Children of preschool age are more often affected, and among adults, women who spend more time with children. With good sanitation and access to water, the incidence of disease decreases sharply.
- Contact with eye and nasal discharge
- Shared towels and bed linen
- Transfer by flies
- Overcrowding
- Lack of clean water
- Preschool children and women caring for them
Symptoms by stage
At an early stage, the complaints resemble ordinary conjunctivitis: redness, mucous discharge, a feeling of sand, eyelids sticking together in the morning. The difference is that the condition lasts for weeks and returns. When the upper eyelid is everted, the doctor sees characteristic follicles and tissue thickening. Over the years, white scar stripes appear in their place. At a later stage, the eyelid turns in, the eyelashes scratch the cornea, severe pain, photophobia and lacrimation occur, and the cornea gradually becomes cloudy. In this case, vision decreases irreversibly.
- Prolonged redness and graininess of the eyelids
- Mucous or purulent discharge
- Foreign body sensation, eyelid stickiness
- Scars on the inner surface of the eyelid
- Turning of the eyelid and growth of eyelashes inward
- Pain, photophobia, corneal opacity
Diagnostics
The basis is an examination by an ophthalmologist with the obligatory inversion of the upper eyelid: this is where follicles, inflammatory thickening and scars are visible. The doctor assesses the stage according to the accepted scale, examines the cornea and checks for inward eyelash growth. Laboratory confirmation of chlamydial infection is used to clarify the diagnosis and assess the prevalence in the outbreak. It is important to exclude other causes of prolonged conjunctivitis: allergies, bacterial and viral infections, dry eye syndrome. When a disease is detected, family members, especially children, are examined.
- Examination with eversion of the upper eyelid
- Stage assessment on a scale
- Examination of the cornea and testing for trichiasis
- Laboratory detection of chlamydia
- Examination of family members
- Exclusion of allergic and viral conjunctivitis
Treatment and prevention
In the early stages, antibiotics prescribed by a doctor are effective; In outbreaks of the disease, treatment is used for the entire family or the entire locality, since isolated treatment of one person does not protect against re-infection. In cases of entropion and trichiasis, surgery is required: it returns the edge of the eyelid to the correct position and protects the cornea. A temporary measure is to remove inward eyelashes, but it does not replace surgery. Prevention is key: regular face washing with clean water, separate towels, fly control, access to water and sanitation. These simple measures break the chain of transmission.
- Antibacterial therapy as prescribed by a doctor
- Treatment of all family members in the outbreak
- Surgical correction of entropion
- Removal of eyelashes for trichiasis as a temporary measure
- Washing your face daily with clean water
- Individual towels and bed linen
- Controlling flies and improving sanitation
