Clinical: Name the condition

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These dramatic and sad images were sent in by Alison Hudson some years back to one of our anterior imaging competitions. They were taken when on a charity visit to Africa. Dramatic, because of the extent of corneal opacification and adnexal scarring. Sad because they are the result of a condition that is still very common throughout the world and is preventable.

Trachoma is still the leading cause of blindness through infection and of the 41 million people estimated to be carrying the active infection 8 million suffer visual impairment because of it. The name comes from the Greek for 'rough eye' and stems from the fact that repeated infection inevitably leads to cicatricial entropion (scar tissue causes the lids to invert) and trichiasis with the result that the corneas are constantly abraded, resulting in corneal neovascularisation and opacification. Destruction of goblet cells and damage to the lachrymal system leave the eye dry. All of this leads to a long-term painful and damaged eye with concurrent loss of vision.