Trachoma in children: causes, symptoms, diagnosis, treatment

Trachoma is an infectious eye disease caused by chlamydia. The defeat of the conjunctiva and the cornea has a chronic course with scarring of the conjunctiva and cartilage of the eyelids.

ICD-10 code

A71 Trachoma.

Epidemiology

Trachoma, a widespread disease in the recent past, is now found in the CIS in single cases, mainly in the southern regions. Up to 90% of newly diagnosed patients are persons with relapses of trachoma.

The source of infection are patients with active forms, especially with erased clinical manifestations, as well as carriers of the pathogen. In the spread of trachoma, a low life level of the population, overcrowding, lack of sanitary skills, etc. Play an important role. Transmission of the infection occurs almost exclusively through direct or indirect contact - through the hands, handkerchiefs, towels, etc.

Classification of trachoma

Depending on the clinical manifestations, follicular, papillary (with predominance of papillary growths), infiltrative (infiltration of the conjunctiva and cartilage of the eyelids) and mixed (detect follicles and papillary outgrowths) forms of the disease are distinguished.

In typical cases, the pathological process goes through four stages:

• I stage - the initial, there are immature follicles, the so-called trachomatous grains with superficial infiltration of the cornea;
• Stage II - active trachoma, follicles develop further (mature follicles) with papillary hyperplasia mainly in the area of transitional folds and cartilage, the formation of pannus and infiltrates in the cornea;
• III stage - scarring of necrotic follicles (scarring trachoma);
• IV stage - cicatricial trachoma with complete replacement of scar tissue of follicles and infiltrates. In essence, this is a cure for trachoma with anatomical defects.

Pathogenesis of trachoma

Initially, the pathogen affects the conjunctiva and epithelial cells of the cornea. Then the process extends to deeper tissues involving the cartilage of the eyelids and the development of cicatricial changes.

Trachoma Symptoms

The incubation period of trachoma is 1-2 weeks. The disease can begin both acutely and gradually. With acute onset of the disease, there is a picture of rapidly progressive conjunctivitis: edema and hyperemia of the eyelids, copious mucopurulent discharge from the eyes, burning sensation and photophobia. With a gradual onset, the first signs of the disease can be minor discharge from the eyes, a sense of awkwardness in the eyes, lacrimation. Inflammatory changes gradually increase. At the height of clinical manifestations, patients complain of pain in the eyes; Conjunctiva edematous, hyperemic.

Diagnosis of Trachoma

Clinical diagnosis of trachoma is based on the detection of follicular conjunctivitis in the upper eyelid, vascular growth in the cornea in the upper limb, cicatricial changes, etc. For laboratory confirmation of the diagnosis, the same methods as in other forms of chlamydial infection are used.

Differential diagnostics

Trachoma is differentiated with paratrahoma, blennorei with inclusions, conjunctival pemphigus, gonococcal conjunctivitis, molluscum contagiosum.

Treatment of Trachoma

For the treatment of trachoma macrolide antibiotics and sulfonamide preparations are used.

Prevention of Trachoma

Specific prophylaxis is not developed. The main importance is the early detection and treatment of patients, as well as extensive sanitary education among the population and strict control of compliance with hygienic requirements in the foci of trachoma.