Trachoma

Trachoma is a contagious eye infection caused by a type of bacteria called  Chlamydia trachomatis. The strains of bacteria that cause trachoma are different from the strains that cause the sexually transmitted infection (STI) chlamydia.

Trachoma is treatable and preventable. It is the most common infectious cause of blindness in the world.

The infection starts in the lining of the eyelid. If you get infected repeatedly, the lining can scar and thicken over time. This can cause your eyelashes to turn inwards and rub on your eyeball. This condition is called trichiasis. It can cause pain and damage the surface of your eye. Repeated infections can cause blindness.

Australia is the only developed country where trachoma is found. Aboriginal and/or Torres Strait Islander people in remote areas of Australia are most at risk.

Symptoms of trachoma may include:

• red, sore eyes
• watery eyes
• discharge (fluid) from your eyes or nose
• follicles (white spots) on the inside of your upper eyelid
• swollen eyelids
• sensitivity to light
• blurred vision

Many people with trachoma do not have symptoms. 

Symptoms usually develop 5 to 10 days after you come into contact with an infected person. 

Trachoma is most common in young children and teenagers. Scarring and in-turned eyelashes (trichiasis) are more common among people over 40 years of age. Scarring can cause the eye to look white or milky. This scarring is irreversible (cannot be fixed).

The bacteria that cause trachoma are spread through direct contact with fluid from the eyes or nose of infected people. Trachoma spreads mostly between young children.

The bacteria can spread through:

• sharing personal items such as face cloths, towels or pillowcases
• flies that touch infected eyes
• coughing and sneezing
• touching your eyes with unwashed hands
• close contact with an infected person

If you are infected, you are contagious for 2 to 3 months. The infectious period may be shorter if you have a repeat infection.

Trachoma is more common in areas where a lot of people live close together. It is especially common in places with limited access to water and poor toilet facilities, which can lead to an increase in flies.

You should see your doctor if:

• your eyes are red or have a discharge
• you feel a need to pull out your eyelashes, because they are rubbing on your eye
• you cannot see well

Your doctor can diagnose trachoma by talking to you and examining your eyes. If you have an active trachoma infection, you may have pale round spots on the inside of your eyelid.

Your doctor may also take a swab of fluid from your eyes to test for the bacteria.

Active trachoma is treated with a single dose of an antibiotic called azithromycin (Opens in new tab). Everyone in your household should also be treated. 

If trachoma is widespread in your community, everyone may get antibiotic treatment.

If you have trichiasis, your doctor may refer you to an eye surgeon to correct the turning in of your eyelid.

Repeated trachoma infections can cause scarring of the inner eyelid. Scarring can make your eyelid turn inwards over time. This causes your eyelashes to rub on the eye, which is painful and causes further scarring. Even one eyelash rubbing on your eye can cause more scarring.

If your trichiasis is not treated with surgery, or if you are infected many times, this scarring can lead to blindness.

Trachoma is linked to poor hygiene and living conditions. Simple steps to improve hygiene can help prevent infection, such as:

• teaching children good hygiene
• making sure family members don't share towels and face cloths
• washing your hands and face regularly
• keeping your environment clean and free from flies
• taking care of your eyes

Improving access to clean water, better sanitation and reducing overcrowding can help stop trachoma from spreading.

The World Health Organisation and the Communicable Disease Network Australia developed the SAFE strategy to end trachoma infections:

• S — surgery to treat trichiasis
• A — antibiotics for infected people and their contacts
• F — facial cleanliness to reduce the spread of infection
• E — environmental improvements such as better access to water, sanitation and housing

Some Aboriginal and/or Torres Strait Islander communities have high rates of trachoma. Adults in communities where trachoma is common should be screened for trichiasis every year.

For more information on trachoma, you can contact your:

• local doctor
• optometrist
• ophthalmologist (eye doctor)

Visit Optometry Australia (Opens in new tab) to find an optometrist.

The Australian Government has more information about trachoma (Opens in new tab).

Information for Aboriginal and/or Torres Strait Islander peoples

Find an Aboriginal Community Controlled Health Organisation (Opens in new tab) or Affiliate near you.

These helpful resources are available from the University of Melbourne's Indigenous Eye Health Unit:

• Clean Faces, Strong Eyes (Opens in new tab) campaign
• Milpa's Six Steps to Stop Germs (Opens in new tab) poster for children

Watch the No Germs on Me (Opens in new tab) video on hand washing.