New steps toward eliminating blinding trachoma [editorial]

Despite long-standing efforts to control it trachoma remains the leading cause of preventable blindness in the world. According to the most recent estimates some 84 million people have active trachoma (the infectious stage) in 55 countries in which the disease is endemic and 7.6 million people have trachomatous trichiasis the blinding stage of this infectious disease. Trachoma is a chronic keratoconjunctivitis caused by repeated reinfection with the ocular serotypes A B Ba and C of Chlamydia trachomatis an obligate intracellular bacterium. The infection causes a mucopurulent conjunctivitis that is generally self-healing without sequelae. In 1998 the World Health Assembly the governing body of the World Health Organization adopted a resolution requesting that all countries where trachoma is endemic join the effort to eliminate blinding trachoma by the year 2020. The World Health Organization advocates the implementation of the SAFE strategy an integrated intervention with four facets: surgery antibiotics facial cleanliness and environmental improvement. Surgery is indicated for advanced trichiasis. For those at imminent risk for blindness because of trichiasis a surgical intervention can reduce or eliminate the risk of corneal damage and irreversible blindness. This procedure takes about 20 minutes and consists of correcting the inward deviation of the upper eyelid which in turn prevents the eyelashes from rubbing against the cornea. (excerpt)