When people think of blindness, they often picture cataracts, glaucoma, or retinal diseases. However, there is another condition that receives less attention but can be just as dangerous — trachoma. It starts as a common bacterial infection, but without timely treatment, it can scar the eyes permanently and cause blindness. What makes trachoma particularly tragic is that it is preventable and treatable, yet it continues to affect millions, especially in underprivileged regions.
According to Dr Sudipto Pakrasi, Chairman of Ophthalmology at Medanta, Gurugram, trachoma is an eye infection caused by a bacterium known as Chlamydia trachomatis. It spreads through direct contact with the eyes or nasal discharge of an infected person. This can happen through hands, clothes, towels, or even flies that carry infected secretions. The disease is most common in areas with poor sanitation, lack of clean water, and crowded living conditions.
The infection primarily affects the conjunctiva, which is the thin, clear layer covering the white part of the eye and the inner surface of the eyelids. In the beginning, trachoma might look like a simple eye irritation, but when the infection keeps returning or remains untreated, it slowly damages the eye and can cause irreversible blindness.
The danger with trachoma lies in its repeated infections. When the bacteria keep infecting the eye over time, the inner eyelid becomes scarred. This scarring causes a condition known as trichiasis, where the eyelid turns inward. When this happens, the eyelashes start rubbing against the cornea — the clear front layer of the eye.
This constant friction leads to pain, redness, and gradual scarring of the cornea. Once the cornea becomes cloudy due to repeated damage, vision starts to fade, and permanent blindness can occur. This process may take several years, which is why many older adults lose their sight due to infections they suffered as children.
Trachoma often begins with mild symptoms that may seem harmless at first. Common early signs include:
Redness and irritation in the eyes
Watery or sticky eye discharge
Swelling of the eyelids
Sensitivity to light
A gritty or uncomfortable feeling in the eyes
If the condition is not treated early, it can progress to more severe symptoms such as:
Eyelids turning inward (trichiasis)
Visible scarring on the inner eyelid
Blurred or cloudy vision
Gradual or complete loss of sight
Children are especially vulnerable because they are more likely to touch their faces, share towels, and come into contact with flies that spread the bacteria. Women also face a higher risk because they often care for children who may already be infected.
Trachoma is most widespread in rural and low-income areas of Africa, Asia, the Middle East, and Latin America — regions where access to healthcare and clean water is limited. In such areas, the infection can spread quickly within families and communities.
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The good news is that trachoma can be prevented and cured if detected early. The World Health Organization (WHO) recommends a simple and effective public health strategy called the SAFE approach to combat trachoma. The acronym SAFE stands for:
S – Surgery to correct trichiasis (inward-turning eyelids) and prevent further damage to the cornea.
A – Antibiotics such as azithromycin to kill the bacteria and stop the infection.
F – Facial cleanliness to prevent the spread of bacteria through direct contact.
E – Environmental improvements, including access to clean water, proper sanitation, and control of flies.
In the early stages, antibiotics can completely clear the infection and stop the disease from progressing. Regular face washing, especially among children, reduces the chance of spreading the bacteria within families.
In advanced cases where scarring has already formed, surgery becomes necessary. Corrective surgery can turn the eyelid back to its normal position, stop the eyelashes from scratching the cornea, and prevent total blindness.
Public awareness and hygiene are crucial in ending trachoma. Communities that have improved sanitation and water supply have seen a sharp drop in infection rates. Health workers in several countries are also educating people about washing hands and faces regularly — simple habits that save sight.
Trachoma is more than just a medical problem; it is also a social and environmental challenge. Poor hygiene, lack of clean water, and poverty allow the infection to spread easily. Eradicating trachoma requires not only treatment but also sustained community action and support from governments and health organisations.
Trachoma serves as a powerful reminder that even the smallest bacterial infection can have devastating effects when neglected. Millions of people, especially in developing nations, continue to lose their sight because of poor living conditions and lack of awareness. Yet, the disease is entirely preventable with basic hygiene, clean water, and timely medical care.
Early diagnosis, antibiotics, and the SAFE strategy can protect entire communities from this painful condition. Public health campaigns have already shown success in many countries, reducing the global number of trachoma cases significantly over the past few decades.
As Dr Pakrasi stresses, “Trachoma is not a disease that should exist in the modern world. With clean water, hygiene, and healthcare access, we can completely eliminate it.”
Trachoma may start as a simple eye infection, but if ignored, it can steal the gift of sight. By recognising symptoms early, maintaining hygiene, and supporting global eradication efforts, the world can ensure that no one loses their vision to a disease that can be easily prevented and cured.
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