OP3.3 | Chronic Conjunctivitis and Trachoma — Summary & Reflection

KEY TAKEAWAYS

Chronic conjunctivitis (>4 weeks) is caused by infective agents (trachoma, angular blepharoconjunctivitis from Moraxella, molluscum, Demodex), immunological mechanisms (phlyctenular conjunctivitis), toxic agents (preserved drops), or degeneration (pterygium). Trachoma — caused by Chlamydia trachomatis serotypes A/B/Ba/C — is the world's leading infectious cause of preventable blindness, transmitted via flies (Musca sorbens), discharge, and fomites. Pathological progression: repeated reinfection → follicular inflammation → conjunctival scarring (Arlt's line) → cicatricial entropion → trichiasis → corneal abrasion → corneal opacity. WHO five-sign grading: TF (≥5 follicles ≥0.5 mm, upper tarsal), TI (>50% deep vessels obscured), TS (scarring/Arlt's line), TT (trichiasis), CO (corneal opacity). Herbert's pits (limbal scars) are pathognomonic. Management: WHO SAFE strategy — Surgery (bilamellar tarsal rotation for TT), Antibiotics (azithromycin 1 g oral single dose; MDA for endemic communities), Facial cleanliness, Environmental improvement.

REFLECT

Trachoma is a disease of poverty — it thrives where clean water, sanitation, and healthcare access are limited. As a future doctor, you may encounter trachoma in your community health posting or rural internship. Reflect: if you identified a child with active TF in a village, what barriers would prevent that child from receiving treatment? What single intervention under SAFE would have the greatest impact if only one could be implemented? Write three sentences in your reflective journal addressing these questions after discussing with your public health faculty.