1. Clinical Manifestation:
The uncomfortable feeling is not obvious at the initial stage, and the disease can only be found through somatoscopy. In most cases, the subjective symptoms are mild with itching, unsmooth, burning, dry and foreign body sensations in the eye. In a few severe cases, there may appear obvious symptoms of irritability and injury of eyesight to some degrees when accompanied by blepharelosis, trichiasis and corneal ulcer.
2. Ocular Examinations:
(1) Chronic inflammatory changes of conjunctiva Diffuse congestion of palpebral conjunctiva, hyperplasia and hypertrophy of papillae, formation of follicles and scars (papillae and follicles are the basic injury of trachoma, indicating there exist active pathogenic changes, and the scar is the result of repairing) ; red and small papillae in clusters, yellowish red or dark red follicles which are large, not transparent, and different in size; and filiform or reticular scars. Continue to read Chinese medicine Treatment for Trachoma.
(2) Corneal pannus Stretching from above the cornea to the superficial transparent area of cornea, the pannus is in the form of curtain-falling which can often be found at the initial stage of trachoma. For the late sever trachoma, neogenetic blood vessels surround the cornea and invade it, even covering the whole cornea. This may greatly affect the vision of a patient.
It is easy to diagnose a typical case of trachoma, but a mild and early one is difficult to determine and can be easily confused with the other corneal disorders because papillae and follicles are not the specific changes of trachoma. According to the Ophthalmology Association of China Association of Medicine, the diagnostic evidences of trachoma should be: a. Obscure vessel congestion of the superior fornix and of the upper palpebral conjunctiva, and papillary hyperplasia or follicular formation, or both of the two; b. Cornea pannus in the magnifier or slip-lamp examination; c. Scars in the superior fornix or in the upper palpebral conjunctiva; d. Chlamydi trachomatis on the scaling section of the conjunctiva.
On the basis of the first item, trachoma can be diagnosed if one of the other items exists.
3. Clinical Stages of Trachoma:
The Ophthalmology Association of China Association of Medicine classifies trachoma into three stages: I. active pathogenic changes (obscure vessel congestion, papillary hyperplasia or follicular formation) in the superior fornix and in the upper eyelid conjunctiva; II. active lesions in the conjunctiva and occurrence of scars; III. no active lesions, only scars in the conjunctiva. Trachoma at the first and second stages is again divided into mild, moderate and severe cases. In mild cases, the active lesion takes up less than a third of the upper conjunctiva and, in moderate cases, it covers a third to two thirds, and more than two thirds in severe cases.
The diagnosis of trachoma, therefore, should involve the course of the disease and the degrees of the pathogenic changes. Trachoma I++, for example, means the condition of the disease is a moderate case at the first stage.
