Ans. is 'b' i.e., Trachoma Trachoma Trachoma, also called Egyptian ophthalmia, is a chronic keratoconjunctivitis primarily affecting the superficial epithelium of conjunctiva and cornea simultaneously. Trachoma is characterized by mixed follicular and papillary conjunctivitis. Trachoma is cuased by chlamydia trachomatis seroptypes A, B, Ba and C. The organism is epitheliotropic and produces intracytoplasmic inclusion bodies called HP bodies (Halberstaedter prowazeke bodies). Clinical features of Trachoma The clinical course of trachoma is determined by the presence or absence of secondary infection. In the absence of such infection, a pure trachoma is so mild and symptomless that the disease is usually neglected and symptoms include mild foreign body sensation and occasionally lacrimation. But, mostly the picture is complicated by secondary infection and may sta with typical symptoms of acute mucopurulent conjunctivitis. On examination the conjunctiva and cornea, both are involved : ? A) Conjunctival signs Congestion of upper tarsal and forniceal conjunctiva. Conjunctival follicles :- Boiled sagograin like follicles are commonly seen on upper tarsal conjunctiva and fornix. Sometimes follicles are present on bulbar conjunctiva and presence of follicles on bulbar conjunctiva is pathognomonic of trachoma. The characteristic feature of trachoma follicle is the presence of necrosis and leber cells (large multinucleated cells) which differentiate it from follicular conjunctivitis. Papillary hyperplasia :- Papillae are reddish, flat topped raised areas which give red and velvety appearance to the tarsal conjunctiva. Conjunctival scarring : - Linear scar present in the sulcus subtarsalis is called Arlt's line. Concretion : - May be formed due to accumulation of dead epithelial cells and inspissated mucus in depressions called glands of Henle. B) Corneal signs Superficial keratitis Herbe follicles : - Follicles in the limbal area. Pannus :- Infiltration of cornea associated with vascularization. Corneal ulcer .. - At the advancing edge of pannus. Herbe pits : - Left after healing of Herbe follicles in the limbal area. Corneal opacity Sequelae and complications of trachoma Sequelae and complications of trachoma are : ? Lids : - Entropion, trichiasis, tylosis, ptosis, madarosis, ankyloblepharon. Conjunctival : - Concretions, pseudocyst, Xerosis (dryness), symblepharon. Corneal : - Corneal opacity, ectasia, corneal xerosis, total corneal pannus, corneal ulcer. Other : - Chronic dacryocystitis, Chronic dacryoadenitis. Blindness