After repeated trachoma infections, the inside of a person’s eyelid can become scarred and turn inward, causing the eyelashes to scrape against a person’s eye with each blink. This condition is called trichiasis, and without immediate, corrective surgery, a person with trichiasis will slowly and painfully become blind.
This is the everted upper eyelid
Only the central area as shown is examined
Any signs must be clearly seen to be reported present
Trachomatous Follicular Inflammation (TF)
TF is 5 or more follicles in the central part of the upper tarsal conjunctiva
The follicles are round swellings that are pale compared to the rest of the conjunctiva
They must be at least 0.5 mm in diameter to be counted
If they are less than 5 follicles, then this is not TF and should not be graded as TF
Trachomatous intense Inflammation (TI)
Active disease is also seen as TI, which stands for trachomatous inflammation intense
There is pronounced inflammatory swelling of the tarsal conjunctiva so that more than half of the deep, normal tarsal vessels are obscured by the swelling
TF should also be diagnosed if 5 or more follicles are seen
Trachomatous conjunctival scarring (TS)
Repeated episodes of inflammation results in TS, which stands for trachoma scarring.
The definition is easily visible white lines, sheets or bands in the tarsal conjunctiva
If the TS is severe, it may result in trichiasis, TT.
At least one eyelash rubbing on the eyeball or evidence of eyelash removal
Corneal Opacity (CO):
If the trichiasis is not treated, it can cause corneal opacity, CO, and loss of vision