الفهرس 
IntroductionOnly 14 pages are availabe for public view
 |  | from | 102 |  |  |
| | | from | 102 | | |
Abstract
Summary
Trachoma is probably the third most common cause of blindness worldwide, after cataract and glaucoma. Current estimates indicate that there are 8 million people who are blind or have severe visual impairment from trachoma, million unoperated trichiasis cases and 84 million with active trachoma. The condition has been endemic in Egypt since old ages.
It afflicts some of the poorest regions of the globe, predominantly in Africa and Asia. The disease is initiated in early childhood by repeated infection of the ocular surface by Chlamydia trachomatis. This triggers recurrent chronic inflammatory episodes, leading to the development of conjunctival scarring. This scar tissue contracts, distorting the eyelids (entropion) causing contact between the eyelashes and the surface of the eye (trichiasis). This compromises the cornea and blinding opacification often ensues.
Childhood inflammatory trachoma has already produced conjunctival scarring which will lead to adult onset trichiasis and blindness in the current population over 15 years of age. It is not clear why inflammatory disease is more prevalent among young males and cicatricial disease is more prevalent among adult females.
The World Health Organization is leading a global effort to eliminate Blinding Trachoma, through the implementation of the safe strategy. This involves surgery for trichiasis, antibiotics for infection, facial cleanliness (hygiene promotion) and environmental improvements to reduce transmission of the organism. where this programme has been fully implemented, it has met with some success. However, there are significant gaps in the evidence base and optimal management remains uncertain.
The emphasis on prevention is essential because the outcome of penetrating keratoplasty in trachoma patients is often disappointing due to extensive corneal vascularization, ocular surface problems, and the invariable presence of entropion and trichiasis. To make matters worse, eye-bank facilities, modern operating rooms and equipment, and adequately trained surgeons and nurses are rare in areas where severe trachoma is endemic. It is essential, therefore, to prevent corneal blindness from occurring by instituting trachoma prevention programmes in areas where the disease is endemic.
The study is aimed to study corneal complications among the population at atfeh central hospital. It was included 50 patients on one group, male and female aged between 20-50 year studying. Trachoma hazards on cornea and vision at Atfeh central hospital outpatient clinic. It extended for 1 year include operation done for repair lid as (entropion, ectropion and electrocautry) which are done by local anesthesia.
The main results of the study revealed that:
• A total of 50 patients were enrolled. The majority of cases (48%) were in the category of more than 50years followed by 24% cases were between 30- 39 years and the least groups presented were 20- 29 years and 40- 49 years.
• Regarding sex distribution, it was noticed that Trachoma was predominant in females (80%) than males (20%).
• The most common complaint was tearing (92%) and itching (60%). And least rubbing lashes.
• In relation to duration of symptoms, trachoma presents mainly after months (56%) or years (40%).
• Trachoma not necessary accompanied by chronic diseases as majority of cases were free. On the other hand, it was noticed that diabetes more common in our study group (16%) as repeated infection due to decrease immunity.
• Only 8% cases had positive family history of eye illness. Trachoma is not necessarily hereditary as it mainly occurs due to environmental factors.
• It was observed that Herbert’s pits and Arlet’s line are the most common presentation in our study group. Pannus, ptds, ptcs are more common at old age and occur after long time of infection.
• All cases require medical treatment in the form of topical eye drops and ointments. Also, all cases needed lubricants and improve hygiene as washing face and avoiding contaminated water. Surgery was needed in only 28% cases.
• It was noticed high ratio of improvement at first four weeks. The highest degree of improvement (42%) was after three weeks. With good follow up recovery is very easy.
• Improvement ratio was almost all cases (98%). Only cases that stop follow up may get worse and complicated.
Based on our results we recommend for further studies on larger patients and longer period of follow up to emphasize our conclusion.