Trachomatous conjunctivitis:

Trachomatous conjunctivitis

Trachoma is a chronic conjunctivitis caused by Chlamydia trachomatis and is characterized by progressive exacerbations and remissions. It is the leading cause of preventable blindness worldwide. Initial symptoms are conjunctival hyperemia, eyelid edema, photophobia, and lacrimation. Later, corneal neovascularization and scarring of the conjunctiva, cornea, and eyelids occur.

Stages of Trachoma

Trachoma usually affects both eyes. Five stages are described in the World Health Organization grading system.

• Trachomatous inflammation-follicular (TF): Characterized by 5 or more follicles in the upper tarsal conjunctiva
• Trachomatous inflammation-intense (TI): Characterized by pronounced inflammatory thickening of the tarsal conjunctiva that obscures more than half of the normal deep tarsal vessels
• Trachomatous scarring (TS): Characterized by scarring in the tarsal conjunctiva
• Trachomatous trichiasis (TT): Characterized by at least one eyelash rubbing the eyeball
• Corneal opacity (CO): Characterized by easily visible corneal opacity over the pupil

Cause

Trachoma is caused by certain subtypes of Chlamydia trachomatis, a bacterium that can also cause the sexually transmitted infection chlamydia.

Trachoma spreads through contact with discharge from the eyes or nose of an infected person. Hands, clothing, towels and insects can all be routes for transmission. In developing countries, eye-seeking flies also are a means of transmission.

Symptoms

Signs and symptoms of trachoma usually affect both eyes and may include:

• Mild itching and irritation of the eyes and eyelids
• Eye discharge containing mucus or pus
• Eyelid swelling
• Light sensitivity (photophobia)
• Eye pain
• Eye redness
• Vision loss

Diagnosis 

The following tests are used to diagnose trachoma: 

• PCR testing developed for urogenital infection is available but typically utilized for research purposes only.
•  cytologic tests (Giemsa stain or direct fluorescent antibodies)
• different cell cultures and enzyme immunoassay methods. 

These three methods have been surpassed in both sensitivity and specificity by nucleic acid amplification tests (NAATs). Currently, there is insufficient evidence to support the use of NAATs for national elimination programs

Inactive: Evaluate based on residuals, such as visual impairment and disfigurement (diagnostic code 7800).