Differential Diagnosis of Trachoma

Trachoma is a chronic infectious disease caused by Chlamydia trachomatis, primarily affecting the conjunctiva and cornea. Its clinical presentation may overlap with other ocular conditions, necessitating a thorough differential diagnosis.

Conditions to Consider

• Bacterial Conjunctivitis: Unlike trachoma, acute bacterial conjunctivitis presents with mucopurulent discharge and lacks follicular hypertrophy.
• Viral Conjunctivitis: Adenoviral infections often mimic trachoma but typically exhibit preauricular lymphadenopathy and do not cause significant scarring.
• Allergic Conjunctivitis: Characterized by itching and chemosis rather than the follicular response seen in trachoma.
• Superior Limbic Keratoconjunctivitis (SLK): SLK involves inflammation of the superior conjunctiva but lacks the scarring and pannus formation associated with trachoma.

Diagnostic Approach

Differentiating trachoma from these conditions requires comprehensive history-taking, slit-lamp examination, and microbiological testing.

Management and Treatment

Management depends on the underlying cause. Trachoma treatment involves the SAFE strategy:

• Surgery: To correct trichiasis and prevent blindness.
• Antibiotics: Azithromycin is the drug of choice.
• Facial Cleanliness: Reducing transmission risk.
• Environmental Improvement: Limiting exposure to infection sources.

Accurate diagnosis is crucial to prevent mismanagement and long-term ocular complications.