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.

Normal eyelid:

  • 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 from the upper eyelid touches the eyeball, or evidence of recent epilation of in-turned eyelashes from the upper eyelid.

Corneal Opacity (CO):

  • If the trichiasis is not treated, it can cause corneal opacity, CO, and loss of vision

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