Abstract
Purpose :
National programs are making great efforts to eliminate trachoma as a public health problem. One criterion for elimination is a prevalence of trachomatous trichiasis of <0.2% in ≥15-year-olds. Recently, discussions have focused on whether trachomatous scarring easily visible to the trachoma grader (TS in the WHO simplified system) should be included in the definition of trachomatous trichiasis. The goal of this analysis was to determine characteristics of eyelids with trichiasis among patients presenting for trichiasis surgery.
Methods :
As part of the ongoing Maximizing Trichiasis Surgery Success (MTSS) trial, we collected information on presence of conjunctival scarring, Herbert’s Pits and pannus for participants receiving first-time trichiasis surgery between August 2019 [SA1] and December 2019 [SA2] in Southern Ethiopia. All participants provide informed consent prior to participation. Each eyelid was examined for presence of trichiasis and associated severity (number and location of trichiatic eyelashes, evidence of epilation, conjunctivalization of the eyelid margin), other signs of prior ocular chlamydial infection and evidence of prior trichiasis surgery. Current analyses are limited to eyelids without prior surgery.
Results :
This analysis includes 1346 eyes with trichiasis[SA1] , prior to first surgery. Among these, 33 (2.4%) had no signs of conjunctival scarring easily(?) visible [SA2] to the grader. Over half of these 33 had at least 1 Herbert’s pit, 2/3 had extensive conjunctivalization of the eyelid margin and 15% had some pannus[SA3] . One participant also had lower eyelid trichiasis in the eye with upper eyelid TT without scarring. Half of the 33 eyelids without scarring had scarring in the contralateral eye.
Conclusions :
The vast majority of eyelids with trichiasis had at least some conjunctival scarring. Among those that did not have easily visible scars, X% had at least one other sign of trachoma. These data suggest that most individuals presenting for surgery in Southern Ethiopia should be considered to have trachomatous trichiasis and should be considered for trichiasis surgery using techniques intended to manage that condition.
This is a 2020 ARVO Annual Meeting abstract.