Trachoma is an infectious eye disease caused by the bacteria Chlamydia trachomatis. This disease is the leading cause of preventable blindness worldwide. All Trachoma cases are both curable and preventable, and never have to reach blinding stages. In 2016, the WHO stated that this bacterial infection was responsible for blindness or severe visual impairments in over 1.9 million people worldwide, yet this is merely the tip of the iceberg. An additional 5 million people require surgery due to the infection, and the WHO determined that the disease is endemic in 41 nations with over 190 million people at risk of being infected. This disease has detrimental effects on people’s quality of life as blindness and pain severely impacts daily living.
This disease spreads through personal contact and by flies that have been in contact with the eyes or nose of an infected person.
The World Health Organization has identified five stages of Trachoma:
Inflammation– Here the infection is just beginning and small bumps are visible on the inner surface of the eyelid. The eye becomes highly infectious, and irritated as the eyelid thickens and swells.
Eyelid scarring- Repeated infections lead to scarring of the inner eyelid and the eyelid start to turn inwards.
Ingrown eyelashes (trichiasis)- The scarred inner lining of the eyelid continues to deform, causing the lashes to turn in so that they rub on and scratch the transparent outer surface of the eye.
Corneal clouding- In this stage, in-turned lashes rub against the eye causing clouding which leads to blindness.
The WHO has proposed the SAFE strategy to eradicate the disease. These strategies consist of treatment and prevention methods.
S -Surgery: Patients that have had the infection for over 10 years begin to go blind as their eyelashes turn inwards and rub against their cornea. This requires surgery to reverse and is where we are currently focusing our efforts.
A – Antibiotics: These are the drugs that kill bacteria within the eye and prevent disease progression and spread.
F -Facial cleanliness.
E- Environmental factors: These strategies target the spread of flies, which carry the disease from person to person. Fly populations can be controlled by effectively dealing with waste water.
To run an effective eradication program all of these factors must be considered.
“I feel like something is constantly piercing into my eyes and I feel like there’s sand in my upper eyelid. It’s so painful and irritating that I feel like I just want to pull my eyes out.”
“It’s been ongoing for a very long time at least 30 years and since I never thought I’d been able to get surgery there was nothing I could do about it.”
Why focus on Trachoma?
Trachoma is a painful eye disease that causes severe pain and vision loss. It is the leading cause of preventable blindness in the developing world, which may make it surprising that you may never have heard of this disease.
Trachoma disproportionately affects the vulnerable populations in countries with limited access to health care. The shocking part is that all of the suffering from this disease is completely avoidable. Trachoma is treatable and preventable, yet it still persists in high numbers around the world. Because this disease causes debilitating pain and vision loss, it is life altering. Many patients are unable to do daily tasks, such as work, take care of children, and in some cases are unable to leave bed. Some of our patients have described it as having sand and needles sticking into their eyes.
In Egypt, this disease is the leading cause of all blindness. Due to the prevalence and severity of this disease, it was the obvious place for us to begin our work. However, if we discover a patient with an eye issue unrelated to Trachoma during screenings, we will do our best to fund the treatment best suited for that patient or refer them to another appropriate organization.