What Is Trachoma?

How Do You Get Trachoma

Trachoma is highly contagious. The infection is transmitted through direct or indirect transfer of eye and nose discharges from infected individuals. Indirect transmission happens via contaminated items such as towels, washcloths, and clothing. The Bazaar Fly (Musca sorbens) acts as a mechanical vector, laying eggs on human feces found on the ground, then seeking out eye and nose moisture in children with active discharge. 

The transmission intensity is inextricably linked to poverty, crowded households, inadequate personal hygiene, lack of clean water supplies, and inadequate sanitation facilities.

Can Trachoma Be Cured?

Whether trachoma can be cured depends on the disease stage.

In its early, active inflammatory stages, trachoma is definitively curable through appropriate antibiotic treatment. Once the infection has progressed to the late, structural stages (scarring, trichiasis, and corneal opacity), the damage sustained by the eyelid and cornea is largely irreversible.

While antibiotics can clear any residual infection, the medication cannot reverse the scarring and distortion of the eye.

How Do You Cure Trachoma?

Early-stage infection can be treated with oral Azithromycin or Tetracycline-based ophthalmic ointment. In endemic areas, Mass Drug Administration (MDA) distributes systemic Azithromycin to entire communities. WHO guidelines require the prevalence of active infection in children aged 1 to 9 years to be reduced to less than 5% and maintained for at least two years without MDA.

For people who have progressed to Trachomatous Trichiasis, surgical intervention is mandatory to prevent irreversible blindness. The Bilamellar Tarsal Rotation (BLTR) procedure can be taught to non-ophthalmologist health workers and performed in rural facilities. The Posterior Lamellar Tarsal Rotation (PLTR) procedure yields superior results regarding reduced recurrence rates. For patients with severe corneal opacity, corneal transplant may be recommended, though this requires advanced clinical settings rarely available in endemic areas.

Why Understanding Trachoma Matters

The global effort to eliminate trachoma has yielded substantial success, with the population at risk declining from over 250 million in 2010 to 113.8 million in 2024. While Mass Drug Administration and surgical intervention provide immediate tools to reduce infection and prevent blindness, sustainability hinges on facial cleanliness and environmental improvement. The evidence showing that scarring is perpetuated by non-chlamydial bacteria and transmission relies on the fecal-ocular-fly pathway indicates that programs must move beyond purely biomedical treatments. Achieving final validation requires maintaining prevalence below 5% in children and eliminating the trichiasis backlog to less than 0.2% in adults, necessitating long-term investment in water access, sanitation infrastructure, and sustained behavioral change.