Trachoma - including symptoms, treatment and prevention
Trachoma is a preventable disease of the eyes caused by infection with the bacteria Chlamydia trachomatis (different from the sexually transmitted form of this germ). It causes loss of vision and blindness in older people who have had severe active trachoma, usually since childhood.
The disease is present in over 40 countries where 1.9 million people have their vision damaged by the infection. Australia is the only developed country with blinding trachoma.
Aboriginal people in remote Australia are most at risk of developing trachoma, with young children the highest risk. Trachoma is a common cause of blindness in Aboriginal adults.
Australia has signed the World Health Organization (WHO) agreement to eliminate blinding trachoma as a public health problem by 2020 and South Australia is on track reach this target.
How trachoma is spread
Trachoma occurs in areas with overcrowded housing where personal and community hygiene are difficult to maintain. The germ is easily spread through infected eye fluids. These fluids are passed back and forth between young children during close contact, such as playing and sharing the same bedding. Flies can also spread the germ.
Children are the main source (reservoir) of infection. Dirty faces are the most important risk factor in the spread of trachoma.
Signs and symptoms of trachoma
Active trachoma in children often causes no symptoms. Trachoma can be present even in children with clean faces. However, children with active trachoma may have red, sore, sticky eyes and discharge from the nose.
The cycle of repeated active infection and resolution occurs over many years. As trachoma progresses in teenagers and young adults, scarring develops under the eyelids. Without treatment the eyelashes turn in and rub on the cornea (the clear part of the front of the eye). This is called trichiasis, and may be painful. Eventually this will cause scarring of the cornea, followed by loss of vision and blindness.
(time between becoming
infected and developing symptoms)
Between 5 to 10 days, but most episodes of infection are reinfections and usually occur in children who already have the disease. Trichiasis usually takes many years to develop.
(time during which an
infected person can infect others)
Between 2 to 3 months. Trachoma is very infectious in its early stage and may be infectious on and off as long as active infection persists.
Diagnosis of trachoma
The diagnosis is made by qualified primary health care staff (Aboriginal health workers, nurses and doctors) taking a history and examining the eye. A swab of the eye may be used to help the diagnosis but is not routinely required
Treatment for trachoma
A single dose of an antibiotic (azithromycin) is the recommended treatment for all people with active trachoma.
This antibiotic is also recommended for the contacts of the person being treated. A contact is anyone who is living and/or sleeping in the same house as a person with trachoma. If the person lives or sleeps in multiple households, then all members of each household are regarded as contacts.
If there is a high rate of trachoma in a community, then all Aboriginal members of the community should be treated with this antibiotic.
Aboriginal adults over 40 years of age in communities where trachoma is usually present (endemic) should be screened annually for trichiasis. Adults who complain of a sore eye also need to be examined for trichiasis. Health services need to ensure timely treatment and referral to an eye surgeon for people with trichiasis.
Prevention of trachoma
The WHO and the Communicable Disease Network Australia recommend the SAFE strategy, 4 actions which aim to eliminate trachoma:
Surgery for trichiasis
Antibiotics (azithromycin) for cases of active trachoma and their contacts
Facial cleanliness by promoting clean faces to reduce spread of infection
Environmental improvements to improve overcrowding, water and sanitation facilities.
Use of the information and data contained within this site or these pages is at your sole risk.
If you rely on the information on this site you are responsible for ensuring by independent verification its accuracy, currency or completeness.
This site includes links to other websites operated by community, business and government.
These linked websites will have their own terms and conditions of use and you should familiarise yourself with these.
All linked websites are linked 'as is' and the Government of South Australia:
does not sponsor, endorse or necessarily approve of any material on websites linked from or to this Site;
does not make any warranties or representations regarding the quality, accuracy, merchantability or fitness for purpose of any material on websites linked from or to this Site;
does not make any warranties or representations that material on other websites to which this site is linked does not infringe the intellectual property rights of any person anywhere in the world; and
does not authorise the infringement of any intellectual property rights contained in material in other websites by linking this site to those other websites.
If you use automatic language translation services in connection with this site you do so at your own risk.
The information and data on this site is subject to change without notice. The Government of South Australia may revise this disclaimer at any time by updating this posting.
The Government of South Australia, its agents, instrumentalities, officers and employees:
make no representations, express or implied, as to the accuracy of the information and data contained on this site
make no representations, express or implied, as to the accuracy or usefulness of any translation of the information on this site or any linked website into another language
make no representations as to the availability of the site and the availability of websites linked from or to the site
accept no liability however arising for any loss resulting from the use of the site and any information and data or reliance placed on it (including translated information and data)
make no representations, either expressed or implied, as to the suitability of the said information and data for any particular purpose
accepts no liability for any interference with or damage to a user's computer, software or data occurring in connection with or relating to this Site or its use or any website linked to this site
do not represent or warrant that applications or payments initiated through this site will in fact be received or made to the intended recipient. Users are advised to confirm the application or payment by other means.