BACTERIAL DISEASES OF THE EYE: OPHTHALMIA NEONATORUM AND TRACHOMA

A bacterial infection in the eye can lead to serious problems, like going permanently blind, if not treated
immediately. There are two types of bacterial diseases of the eye: the first is bacterial conjunctivitis, and
the second is bacterial keratitis. In this chapter, it will be discussed the bacterial conjunctivitis, also
known as the pink eye, wherein the infected area is on the conjunctiva, the outer layer of cells that covers
the eyeball and insides of the eyelid that turns pink or red when irritated or inflamed and also functions in
secreting mucus and tears. It is a highly contagious disease that can be caused by many bacteria,
examples of diseases are Ophthalmia neonatorum and Trachoma, which will be further discussed.

Ophthalmia neonatorum, also called neonatal conjunctivitis, occurs in newborns during the first 28 days
of life. Newborns acquire this disease by passing through the birth canal of an infected mother. It is watery
due to a chemical irritant or a pathogenic organism. The signs that indicate you have the infection include
chemosis, or swelling of the conjunctiva, redness of the eye, and purulent discharge. Although this disease
can be asymptomatic, practicing good hygiene is essential. Newborns gets infected during the delivery of a
mother who is suffering from Neisseria gonorrhoeae, also known as gonococcus, a common cause of
sexually transmitted disease. It appears from birth to 5 days and rapidly develops, resulting in a more
serious case of neonatal conjunctivitis that can lead to corneal ulceration, perforation, and eventually
blindness. Adults may harbor this infection through finger-to-eye contact with infectious genital secretions. It
can be prevented by instilling 1% silver nitrate upon delivery or 1% tetracycline eye ointments.
 
These shows gonococcal ophthalmia.Symptoms and signs of eyelid
edema,chemosis, and purulent discharge develops 2 to 5 days after delivery.

Another cause is the Chlamydia trachomatis bacteria, which is also a cause of sexually transmitted
disease. It develops from the 5th day until the 14th day of the baby, slowly decreasing the risk for
blindness. Thus, it requires systemic therapy such as systemic erythromycin.
 
This shows chlamydial conjunctivitis on newborn.

Trachoma is chronic keratoconjunctivitis, a disease of the eye and the leading cause of preventable
blindness. This disease occurs more in areas with a poor population, such as rural areas that have
insufficient supplies of water, poor sanitation, and poor healthcare. Africa is reported to have the most
cases of trachoma. The disease starts as mild itching and irritation of the eyes and eyelids that later turns
to swollen eyelids with pus discharge and becomes photophobia. Trachoma that has been left untreated
since childhood may progress until adulthood. According to the World Health Organization, they have
identified five stages of the development of trachoma.
Inflammation - follicular. In this stage, there are five or more follicles present on the upper eyelid. Follicles
are round swellings that are white, yellow, or gray in color.
Inflammation - intense. In this stage, upper eyelid appears to be red from inflammatory thickening of the
tarsal conjunctiva.
Eyelid scarring. Due to infection, scars or white lines, bands, or sheets appear on the inner eyelid when
examined with magnification.
In-turned eyelashes (trichiasis).  During this stage, the eyelashes turn in, which results in rubbing and
scratching the outer surface of the eye.
Corneal clouding (opacity). In this stage, the cornea gets clouded due to inflammation of the upper
eyelid.

This disease is caused by Chlamydia trachomatis, which is also the bacteria responsible for sexually
transmitted infections. It is a contagious disease that can be transmitted through direct and indirect contact
with the nasal and ocular discharges of an infected person, through fomites, or by eye-seeking flies.
Trachoma can be prevented by practicing a good hygiene. The World Health Organization developed a
strategy to prevent Trachoma which is the SAFE. 
 
Surgery to treat advanced forms of trachoma
Antibiotics to treat and prevent the infection
Facial cleanliness
Environmental improvements, particularly in water, sanitation and fly control