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

Young children are particularly susceptible to infection. But the disease progresses slowly, and the more painful symptoms may not emerge until adulthood.

The World Health Organization (WHO) has identified five stages in the development of trachoma:

• Inflammation — follicular. The early infection has five or more follicles — small bumps that contain lymphocytes, a type of white blood cell — visible with magnification on the inner surface of your upper eyelid (conjunctiva).
• Inflammation — intense. In this stage, your eye is now highly infectious and becomes irritated, with a thickening or swelling of the upper eyelid.
• Eyelid scarring. Repeated infections lead to scarring of the inner eyelid. The scars often appear as white lines when examined with magnification. Your eyelid may become distorted and may turn in (entropion).
• In-turned eyelashes (trichiasis). The scarred inner lining of your eyelid continues to deform, causing your lashes to turn in so that they rub on and scratch the transparent outer surface of your eye (cornea).
• Corneal clouding (opacity). The cornea becomes affected by an inflammation that is most commonly seen under your upper lid. Continuous inflammation compounded by scratching from the in-turned lashes leads to clouding of the cornea.

All the signs of trachoma are more severe in your upper lid than in your lower lid. Without intervention, a disease process that begins in childhood can continue to advance into adulthood.

When to see a doctor

Call your doctor if you or your child has itchy or irritated eyes or discharge from the eyes, especially if you live in or recently traveled to an area where trachoma is common. Trachoma is a contagious condition. Treating it as soon as possible helps prevent serious infection.