EYE DISEASE: TRACHOMA DISEASE

TRACHOMA DISEASE.

Trachoma is the leading cause of eye problems like blindness among people worldwide. This disease is associated with poor hygiene and inadequate sanitation.

    Chronic granulomatous kerato-conjuvtitis. Is caused by chlamydia trachomatics. Affect most children age who can develop blind at later age.This disease can spread by conjuctival sectrections by towels,flies,and finger.

Begins in early childhood with repeated infection of the conjunctiva by Chlamydia trachomatis, the causative agent. This triggers recurrent episodes of chronic conjunctival inflammation (active trachoma Conjunctival scarring, which is believed to be immunopathologically mediated, develops progressively over many years. The scar may contract, pulling the eyelids in

(entropion), resulting in contact between the eyelashes and the eye (trichiasis). This damages the cornea, and blinding opacification often follows.
active trachoma and 7.6 million with sight-threatening trichiasis requiring surgery

Trachoma is the leading infectious cause of blindness worldwide. It is a considerable public health problem,afflicting some of the poorest regions of the globe, predominantly in sub-Saharan Africa and Asia. In 2003, the WHO estimated that there were 84 million people having

 

Symptoms and Signs.

Clinically, trachoma is subdivided into Active (early) and (late-stage) disease. Active disease is more commonly found in children.

The individual may have minimal symptoms of ocular irritation and a slight watery discharge. In more severe cases, there may be photophobia and copious watering. However, it is not uncommon to find asymptomatic individuals with significant conjunctival inflammation.

Active disease is characterized by a chronic, recurrent follicular conjunctivitis, most prominently involving the upper tarsal conjunctiva Follicles are collections of lymphoid cells subjacent to the conjunctival epithelium.

They range from 0.2 to 2 mm in diameter, but only those greater than 0.5 mm are considered significant in the WHO classification scheme.Intense cases are characterized by the presence of papillary hypertrophy. When mild, there is engorgement of the small vessels appearing as small red dots with surrounding oedema within the tarsal conjunctiva. In more severe.

 

                                         

Pathophysiology of Trachoma
 The Stimulus for Inflammation
and Scarring in Trachoma

Chronic inflammation is a central event in the development of scar tissue in many human diseases. The ocular surface is no exception; inflammation leads to scarring in conditions such as mucus membrane pemphigoid and Stevens – Johnson syndrome. Clinically, active trachoma is characterized by episodes of chronic conjunctivitis. In children, the median duration has been estimated to be 36 weeks, and in adults, 7 weeks [35] . It seems likely that this chronic, recurrent inflammatory process results in the development of conjunctival scarring. Long-term epidemiological studies examining the development of scarring have identified a sub-group of people who have. severe inflammatory trachoma (TI) on repeated examination.

 These individuals are at greatest risk of developing scarring and trichiasis in later life What is driving inflammation in trachoma? There is a consensus in the literature that, for the majority of people,serial reinfection of the conjunctiva by C. trachomatis is the major stimulant to the development of the cicatricial complications, although direct microbiological evidence

for this from long-term epidemiological studies is very limited . In primate models, conjunctival scarring only developed after many episodes of C. trachomatis reinfection . An alternative view, which may be true for a minority, is that the infection becomes persistent,driving the inflammation .
for this is limited.
The signs of trachomatous inflammation can often be found in the absence of detectable C. trachomatis. One possible explanation for this is that other nonchlamydial bacterial pathogens could also be provoking an inflammatory response. Such pathogens are more commonly
found in individuals with conjunctival scarring and inflammation compared to controls, particularly where trichiasis is also present.
In adults with trachomatous scarring, the conjunctival epithelium is atrophic, often only one cell thick and goblet cells are lost [1] . The loose sub-epithelial stroma (normally collagen types I and III) is replaced with a thick scar of collagen type V. Along the conjunctival basement membrane, collagen type IV is laid down.
These new fibers are orientated vertically, and are firmly attached to the posterior surface of the tarsal plate, causing distortion [1] . Biopsies from some scarred individuals have an inflammatory infiltrate dominated by T-cells, corresponding to clinical conjunctival inflammation,which is frequently observed in people with established trichiasis.
glands and a chronic inflammatory infiltrate

In vitro studies suggest that the organism may transform into a persistent nonreplicating form when stressed, although, evidence for this has not been found in vivo. From studies on monkeys, it has been found that conjunctival inflammation develops in response to chlamydial Heat Shock Protein60 (HSP60), which is found within live whole organisms . Heat shock proteins are found in both eukaryotic and prokaryotic cells, and have extensive sequence homology; they are induced when a cell is under stress.

 It has been suggested that the chronic inflammatory reaction in trachoma could be partly an autoimmune reaction to the human equivalent of HSP60; however, the evidence

 This has led to the suggestion that at least in the late  stages of the disease,they could promote disease progression, and are highly likely to contribute to the corneal pathology.

III, and IV (normally found in the stroma) and deposition of new type V [13].

The tarsal plate is usually of normal thickness, but there is often atrophy of the meibomian

 

 

ummary for the Clinician

■ Blinding trachoma is the end-stage of a chronic inflammatory process in the conjunctiva, which produces scarring ■ The main stimulus for this inflammation is C. trachomatis; however, it is the immune response to the infection that damages the tissue and leads to scarring

 

Trachoma Control
 The SAFE Strategy.

Trachoma is a major public health problem in many endemic countries, and controlling it requires a “public health” approach that goes beyond the ophthalmology clinic. Many countries have had organized control programs for decades.

These have taken different approaches to prevent the blinding disease, which have met with

variable success. To meet this challenge, in 1998 the World Health Assembly resolved to eliminate blinding trachoma by the year 2020 [89] . The Global Alliance for the Elimination of Blinding Trachoma (GET2020) was formed, which includes representatives from the WHO,
national blindness control programs from endemic countries, NGOs working in the field, industry, and academics. The GET2020 alliance recognized the importance of a multifaceted approach to controlling trachoma by adopting and promoting the SAFE Strategy. The four
components of SAFE are Surgery for trichiasis, Antibiotics for infection, Facial cleanliness, and Environmental improvements to reduce transmission. In the following sections, supporting evidence and important issues around the implementation of the SAFE Strategy will be
reviewed.

 

ummary for the Clinician

■ The SAFE Strategy is being implemented by prevention of blindness programs to control trachoma ■ Surgery for trichiasis reduces the risk of corneal blindness, but the recurrence rates are high ■ Antibiotics can be effective in controlling the endemic infection if community wide treatment with high coverage rates is given ■ Face washing and environmental improvements help to limit the transmission of infection

 

Conclusion.

Trachoma remains the commonest infectious cause of blindness worldwide, and in many endemic regions, it is second only to cataract. During the last few decades,
real progress has been made in controlling the disease.Trachoma was endemic in Europe 100 years ago, where it declined in the face of general improvements in living standards: less crowding, improved sanitation and water supply. Similar improvements have happened or are happening in parts of currently endemic countries.However, for many communities, it may take many decades for these general improvements to arrive and have an impact on trachoma. Therefore, it is necessary to actively implement the SAFE Strategy as the best validated approach to the prevention of blindness from trachoma. (SEE DIABETIC CONDITION)
 

   

1. CORONA VIRUS
2. MONKEY POX
3. VAGINAL DRYNESS
4. FIBROID
5. INFERTILITY
6. OVULATION CYCLE
7. OVARIAN CANCER
8. VAGINAL BACTERIA
9. MALE INFERTILITY
10. BEST DAYS OF CONCIEVING
11. MUCUS AFTER OVULATION
12. FOODS FOR ERECTILE FUNCTIONS
13. PREGNANCY ANEMIA
14. DO AND DONT DURING PREGNANCY
15. ERECTILE DYSFUNCTION
16. U.T.I IN PREGNANCY
17. STROKE RISK
18. EAT THIS NOT THAT
19. HOOKWORMS INFECTION
20. OMEGA 3 BENEFITS
21. FASTING
22. WEIGHT LOSS TIPS
23. vitiligo
24. ABORTION
25. DENGUE VIRUS
26. EBORA VIRUS
27. FEVER
28. URINARY TRACT INFECTION
29. HOSPITAL INFECTIONS
30. WEST NILE VIRUS
31. YELLOW FEVER
32. EYE DISEASE
33. ZIKA VIRUS
34. STRESS
35. IRON DEFFICIENCE
36. INSOMNIA (SLEEPING PROBLEMS)
37. HEART PROBLEMS
38. COMPONENTS OF BLOOD
39. BLOOD DISORDER
40. LABORATORY TEST OF BLOOD DISORDER
41. BONE MARROW EXAMINATION
42. BLOOD ANEMIA
43. ANIMAL BITES
44. EYE BURN
45. CHOCKING
46. HEAT STROKE
47. SMOKE EFFECTS
48. SNAKE BITE
49. MALARIA VACCINE
50. BEST WAY TO SLEEP A CHILD
51. CHILD FEVER REDUCING
52. ELEPHANTIASIS
53. WOMEN BEARDS
54. DATES
55. PAPAYA FRUITS