Trachoma

Trachoma - specific infectious keratoconjunctivitis caused by a virus from the group fever. Disease is the result of the migration contagious detachable with the patient conjunctiva in good hands, or through contaminated detachable items. The incubation period 5-14 days.
The disease is usually bilateral, begins unnoticed by the patient, and only in rare cases - acute flows chronic, characterized by conjunctivitis with the formation of the follicles (grains) and lesions of the cornea in the form of surface vascular inflammation - pannus (see). The collapse of the follicles causes scarring.

trachoma
Fig. 1. Trachoma stage I. Fig. 2. Trachoma stage III with inversion and trichiasis lower eyelid. Fig. 3. Pannus with "eyes" in Bonn limbus region. Fig. 4. Intracellular inclusions of Prowazeki-Halberstadter with trachoma.

In the clinical course of trachoma there are 4 stages. Stage I - the increase inflammation, diffuse infiltration, conjunctival edema with the development of follicles which have the form of cloudy gray grains, located randomly and deeply in the conjunctiva of transition folds; there initial signs of infection of the cornea in the form of pannus (Fig. 1). Stage II - amid increasing infiltration and development of follicles begin the collapse of the follicles and appear scars. The defeat cornea more pronounced. Stage III is dominated by the process of cicatrization in the presence of follicles and infiltration (Fig. 2). Stage IV (inactive) - spilled scarring affected the mucous membrane in the absence of any inflammation of the conjunctiva and cornea.
Specific defeat cornea with trachoma - pannus - begins from the upper limb, and then infiltration and the newly-formed vessels capture the surface layer of the cornea.
The diagnosis. For early detection of primary trachoma, erased its forms and relapse is vital to use the optical diagnostics - binocular magnifier when mass inspections and slit lamp for the study difficult to diagnose cases (see Biomicroscopy). Characterized by infiltration of the conjunctiva, the involvement of the cartilage (trahaetsy pseudopod), changes of the cornea (pannus).
Laboratory diagnosis includes 3 types of research: scraping the conjunctiva for detection of Taurus Prowazeki - Halberstadter, cytological picture content follicle, virus isolation. Auxiliary importance epidemiological analysis, survey of the center.
Forecast of trachoma currently favorable with timely and proper treatment. In severe and prolonged duration of trachoma may experience intense cornea with a decrease in vision and rough common scars in the conjunctiva. Scarring can cause curvature of the cartilage, roll the century (see) and irregular arrangement of eyelashes (trichius). This lashes RUB the cornea, causing damage to the surface and contributes to the development of ulcers in the cornea.
The group resistant trachoma include cases not amenable to conventional treatment methods. In the basis of the persistent flow of trachoma can lie by various factors: the General disease, loss of strength of the patient, allergic reactions, concomitant disease of the eyelids, conjunctiva and lacrimal system, irregular and improper treatment.
Trachoma, formerly quite common in the USSR, now as a mass disease eradicated. Typical clinical forms are rare.
Treatment. Patients with active trachoma (I - III stages, relapses of the disease) subject to hospitalization. Treatment is 1% ointment tetracycline, erythromycin or oletetrina 4-6 times a day. After 1-2 weeks of starting treatment by a doctor or a specially prepared average health worker is squeezing (expression) follicles special forceps after anaesthesia mucous membrane dropping 0.5% solution dikaina or the introduction of 1 % solution novokaina under the conjunctiva. Eyelids turn and conjunctiva squeeze branches of tweezers. After the expression of ointment antibiotic. Outpatient treatment is possible only in mild cases of trachoma; antibiotic ointments applied 2-3 times a day, 1% ditetracyclinum ointment - 1 once a day or every other day, buried 1% solution tetracycline hydrochloride or 10% solution of sodium sulfapiridazin- on the polymeric base 1-2 times a day.
After clinical cure patients remain in the dispensary and undergo a medical check-up to 4 times a year.
Relapse prevention of trachoma, their early detection and treatment is particularly important for trachoma control, as it is the recurrence of trachoma constitute the basic number of newly registered active cases of trachoma and unrecognized in a timely manner - can be a source of infection. The best prevention of recurrence of trachoma is timely treatment of bacterial and viral conjunctivitis.
An important preventive measure is sanitary and educational propaganda, aimed at observance of the skills for personal hygiene. Sick or recovering from trachoma should have a separate towel, pillow, and so on