Clinical manifestations of trachoma can be divided into 2 clinical phases: active trachoma and cicatricial disease.
Active trachoma – Active trachoma is mostly seen in young children and occurs after a 5-10 day incubation period from exposure. While most individuals are asymptomatic, signs and symptoms can include the following:
- Swelling of the eyelids from formation of follicles on the superior tarsal conjunctiva
- Eye irritation
- Mucopurulent discharge
- Marked conjunctival inflammation
- Entropion – Conjunctival scarring leading to inward turning of the eyelid
- Trichiasis – Ingrown eyelashes from entropion causing irritation of eyeball and cornea
- Corneal edema, ulceration, and scarring due to trichiasis, resulting in corneal pannus (inflammatory vascular tissue) followed by corneal opacity, and eventually blindness
A71.9 – Trachoma, unspecified
2576002 – Trachoma
- Viral conjunctivitis (eg, adenovirus) – Acute, self-limited
- Inclusion conjunctivitis – Usually in an area where trachoma is non-endemic; will isolate the genital serovars of C. trachomatis (serovars D through K).
- Bacterial conjunctivitis (eg, Streptococcus pneumoniae, Moraxella spp.) – Sometimes concurrent upper respiratory tract infection.
- Toxic conjunctivitis – Cosmetics, chemical exposure
- Trauma (eg, corneal abrasion) – May cause corneal scarring or clouding but can be differentiated based on history.
- Vernal keratoconjunctivitis – May have a history of atopy.
- Parinaud oculoglandular syndrome (eg, from cat-scratch disease) – Unilateral
- Cicatricial pemphigoid – Look for involvement of the mouth and gums.