To identify communities with high rate of active trachoma for prioritizing interventions, the sampling method of ASTRA (Acceptance Sampling Trachoma) was applied in this study in order to find the active trachoma rate among pupils at primary schools in Binh Xu yen district, Vinh Phuc province. The results showed that 3 out of 13 communes had high rates of active trachoma among primary school children. The mean rate of active trachoma among these pupils was 8.2% (95%CI: 6.5%. 9.9%). Some risk factors of active trachoma among these subjects include unsafe water for face washing, sharing face cloth, children with dirty face, unsanitary latrines, high density of home flies, and low family income.
Trachoma ; Child ; Schools

The author operated 34 cases of pterygia by Newton's method, wihich combined Mc Raynold's transplantation with limbal incision, in these 34 case, 4 cases were recurred, and in other 2 cases, a few vessels only found on the operated area of the cornea. Among these 6 cases, one had trachoma, 3 had chronic cat conjunctivitis. Auther thinks that the chronic inflammation such as trachoma or chronic conjunctivitis is very important factor in the recurrence of pterygia. This fact also encourages the author who believes that the inflammation is rather more important factor in the etiology of the pterygia than the degensration.
Animals ; Cats ; Conjunctivitis ; Cornea ; Inflammation ; Pterygium* ; Recurrence ; Trachoma

On 2,372 ophthalmic patients that received ocular examination and treatment by the author's medical service intended for doctor less farming and island villages, analyses were done according to disease entity, age, sex and district. The results were as follows: 1. Of the 2,372 patients, male was 384 (25.4%) and female 1,129 (74.6% and total 1,513 in farming districts, male 356 (41.4%) and female 503 (58.6%) and total 859 in island districts. Female far outnumbered male. 2. The most common ocular disease is pterygium (458 of 1,513, 30.3%) in farming districts and chronic catarrhal conjunctivitis (249 of 859, 29.0%) in island districts. 3. Of the pterygium patients, male was 77 (16.8%) and female 381 (83.2%) of 458 (30.3%) in farming districts, male 37 (30.3%) and female 85 (69.7%) of 122 (14.2%) in island districts. There was predominantly high incidence in farming districts, female and the age groups of the fifth and sixth decade. 4. In the nasolaorimal duct obstruction patients, male was 16(17.2%) and female 77(82.8%) of 93 (6.1%) in farming districts, male 12 (27.3%) and female 32 (72.7%) of 44 (5.l%) in island districts. There was no significant difference of the incidence in both districts, but mostly they were female and the age group from the fifth to seventh decade. 5. Of the cataract patients, male was 20 (24.7%) and female 61 (75.3%) of 81 (5.4%) in farming districts, male 10 (38.5%) and female 16 (61.5%) of 26 (3.0%) in island districts. There showed significant high incidence over age 50. 6. In the glaucoma patients, male was 3 (33.3%) and female 6 (66.7%) of 9 (0.6%) in farming districts, male 2 (40.0%) and female 3 (60.0%) of 5 (0.6%) in island districts. 7. Of the trachoma patients, male was 2 (28.6%) and female 5 (71.4%) of 7 (0.5%) in farming districts, male 24 (42.9%) and female 32 (57.1%) of 56 (6.5%) in island districts. Island districts and female were more predominant. 8. Of the 694 cases that required operation, only 287 (41.4%) received surgical procedures and on concerning to pterygium which was the majority, operations were done in 208 (35.9%) of cases.
Cataract ; Common Cold ; Conjunctivitis ; Female ; Glaucoma ; Humans ; Incidence ; Male ; Pterygium ; Trachoma

The term "entropion" is defined as a turning inward of the eyelid. Depending on the mechanism of its causation, it may be classified into four types; mechanical, spastic, senile, and cicatricial. Cicatricial entropion follows scarring of the palpebral conjunctiva, which may be caused by trauma, chemical injuries, infections such as trachoma, benign ocular pemphigus, Stevens-Johnson syndrome, and eyelid surgery. Distichiasis is a rare congenital anomaly in which aberrant separate row of lashes usually composed of hairs smaller than normal, appears along the posterior lid margin. Numerous surgical procedures have been described for surgical correction of cicatricial entropion and distichiasis in accordance with the severity of the condition. We have treated cicatricial entropion in 6 eyes(8 lids) and distichiasis in 3 eyes (3 lids) with sliding tarsoconjunctival grafting, and the results were satisfactory.
Cicatrix ; Conjunctiva ; Entropion* ; Eyelids ; Hair ; Muscle Spasticity ; Pemphigus ; Stevens-Johnson Syndrome ; Trachoma ; Transplants

BACKGROUNDThis research aims at identifying relative interventions on trachoma and testing the effectiveness of control measures adopted by assessing its prevalence and related risk factors in Shandong province of China.

METHODSTrachoma rapid assessment (TRA) was conducted in 6 sub-districts selected from Shandong province based on primary high risk assessment. Active trachoma in children aged 1-9 years and environmental risk factors of trachoma (unclean faces, absence of running water, and absence of flush toilets) were assessed (TRA 1). Control measures were taken in endemic areas. A second TRA (TRA 2) was conducted after 12 months in the same 6 districts and findings of the two TRAs were compared.

RESULTSIn TRA 1, we found trachoma in 3 sub-districts and the detection rate was 4% (95% CI: 0.39%-11.12%), 6% (95% CI: 1.18%-14.17%), and 6% (95% CI: 1.18%-14.17%) respectively. We could not find trachoma cases in TRA 2. Research data supports that children living with environmental risk factors face an increased risk to active trachoma. However, we could not find statistical evidence for this association, which may be caused by the limited data on prevalence.

CONCLUSIONSThis research indicates that the TRA methodology is easy to assess trachoma and its related risk factors. Based on the results of this study, we have already achieved the goal of "elimination of trachoma" in Shandong province, as the detection rate of trachomatous inflamation follicular/trachomatous inflammation intense in 1-9-year-old children was less than 5%.

Child ; Child, Preschool ; China ; epidemiology ; Female ; Humans ; Infant ; Male ; Prevalence ; Risk Factors ; Trachoma ; epidemiology

BACKGROUNDS: Azithromycin mass drug administration (MDA) is a key part of the strategy for controlling trachoma. This systematic review aimed to comprehensively summarize the present studies of azithromycin MDA on trachoma; provide an overview of the impact of azithromycin MDA on trachoma in different districts; and explore the possible methods to enhance the effectiveness of azithromycin MDA in hyperendemic districts. METHODS: PubMed, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and ClinicalTrials.gov were searched up to February 2021 with no language restriction. Studies reporting the effect of azithromycin MDA on trachoma were included. Mathematical modeling studies, animal studies, case reports, and reviews were excluded. The trachomatous inflammation-follicular (TF) <5.0% was used to judge the effect of azithromycin MDA on eliminating trachoma as a public health problem. Two researchers independently conducted the selection process and risk of bias assessment. RESULTS: A total of 1543 studies were screened, of which 67 studies including 13 cluster-randomized controlled trials and 54 non-randomized studies were included. The effect of azithromycin MDA on trachoma was closely related to the baseline prevalence in districts. For the districts with baseline prevalence between 5.0% and 9.9%, a single round of MDA achieved a TF <5.0%. For the districts with baseline between 10.0% and 29.9%, annual MDA for 3 to 5 years reduced TF <5.0%. However, for the districts with high level of baseline prevalence (TF >30.0%), especially with baseline TF >50.0%, annual MDA was unable to achieve the TF <5.0% even after 5 to 7 years of treatment. Quarterly MDA is more effective in controlling trachoma in these hyperendemic districts. CONCLUSIONS Azithromycin MDA for controlling trachoma depends on the baseline prevalence. The recommendation by the World Health Organization that annual MDA for 3 to 5 years in the districts with TF baseline >10.0% is not appropriate for all eligible districts.
Anti-Bacterial Agents/therapeutic use* ; Azithromycin/therapeutic use* ; Humans ; Infant ; Mass Drug Administration ; Prevalence ; Trachoma/epidemiology*

This essay examines the period between 1897 and 1910, when trachoma, a contagious eye disease, became an "Oriental" problem that justified exclusionary immigration policy against Asians entering the United States. It also investigates the ways in which the public fear and alleged threat of the eye disease destabilized and undermined the rights of Asian immigrants. Many scholars have explored the link between trachoma and southern and eastern European newcomers, in particular Jews, but they have not paid much attention to Chinese or Japanese immigrants, for whose exclusion trachoma played a significant role. This is primarily because the number of Asian immigrants was much smaller than that of their European counterparts and because the Chinese Exclusion Acts, which had already been in place, functioned as a stronger and more lasting deterrent to Asian immigration than exclusion or deportation through medical inspection. Moreover, into the 1910s, medical and scientific innovations for detecting parasitic diseases (e.g. hookworm) helped American authorities exclude Asians in larger numbers. Still, the analysis of the discourses surrounding trachoma and immigration from Asia, though short-lived, demonstrates the role of medical inspection in controlling and regulating Asian immigrants, in particular Chinese and Japanese, into the United States and in constructing their legal and political rights. In 1906, the fear of trachoma justified an order to segregate Japanese students from white children in San Francisco even at the cost of compromising their rights as citizens. Along with fierce criticisms against immigration officials by the American public, the 1910 investigation of the San Francisco Immigration Office problematized the admission of trachoma-afflicted Asian immigrants. Those critical of the Immigration Office and its implementation of American immigration policy called for exclusionary measures to limit the privileges of exempt classes and domiciled aliens and hinder the exertion of their rights to leave and reenter their adopted country. The two examples show that trachoma was a convenient excuse to condemn inefficient immigration policy and regulate allegedly diseased Asian bodies. In 1910, the federal government made a decision to relegate to steamship companies full responsibility for medical inspection at Asian ports. Since they had to pay a fine for every immigrant excluded at American borders for medical reasons, including trachoma, steamship companies carried out more rigorous examinations. With medical advancements and growing interest in parasitic diseases, trachoma soon lost its appeal to immigration authorities. However, the association of immigration, race, and disease has continued to provide a rationale for immigration control beyond American borders.
Emigrants and Immigrants/*history/legislation & jurisprudence ; Emigration and Immigration/*history/legislation & jurisprudence ; Far East/ethnology ; History, 19th Century ; History, 20th Century ; Humans ; Trachoma/ethnology/*history/prevention & control ; United States

PURPOSE: To report a case of Salzmann's nodular degeneration caused by chronic irritation from dry eye and trichiasis. METHODS: A 40-year-old female patient visited our ophthalmology clinic complaining of dryness in both eyes. History taking, measurement of visual acuity and intraocular pressure, and slit-lamp examination were performed. RESULTS: We found greyish white nodular opacities which protruded from the inferior corneal surface, and trichiasis at the lower eyelids. Epilation was performed, artificial tear, and lubricating ointment were prescribed, and therapeutic lens was applied. After 3 months of treatment, the symptom was relieved and nodular opacities diminished. CONCLUSIONS: Phlyctenular keratitis, vernal keratoconjunctivitis, trachoma, scarlet fever, postoperative corneal surgery, hard contact lenses, and keratoconus are well known for the course of Salzmann's nodular degeneration. The chronic irritation from dry eye and trichiasis could be the cause of Salzmann's nodular degeneration.
Adult ; Conjunctivitis, Allergic ; Contact Lenses ; Eyelids ; Female ; Hair Removal ; Humans ; Intraocular Pressure ; Keratitis ; Keratoconus ; Ophthalmology ; Scarlet Fever ; Tears ; Trachoma ; Trichiasis* ; Visual Acuity

Blindness is a worldwide health problem which affects at least 10 million people presently. The leading causes of preventable blindness in the world are trachoma, onchocerciasis, and xerophthalmia. The causes of blindness have been surveyed in many countries throughout the world, however they have varied with the country and nation. Even though there have been few reports on blindness in Korea, the nationwide surver has not been done yet. Before the survey is done, the blindness should be defined. But the definition of blindness varies in accordance with social, economical and educational status of that country. To standerdize the definition of blindness, the International Association for the Prevention of Blindness defines the visual acuity for distant vision of 5/200 or less of the better eye. In Korea. blindness has been defined. variably from visual acuity of counting finger/1 m to 20/200 or less, by serveral authors. In this survey. 1,369 patients who have visual acuity of 20/200 or less in one eye or in both eyes have been observed statistically from January 1972 to October 1978. 1. Number of blind patient .......... 1,369 (3.55%). 2. Type of blindness; Number of binocular blindness .......... 312 (22.79%), Number of monocular blindness .......... 1,057 (77.21%), Number of blindnel!s involving the left eye .......... 552(40.32%), Number of blindness involving the right eye .......... 505 (36.89%). 3. The sex and age of the blind patient; 803 persons (58.7%) were male and 566 persons (41.3%) were female. 219 persons (16.0%) were between 21 and 30 years of age, which was the highest rate. 113 person (8.3%) were over 71 years of age, which was the lowest rate. But the age distribution of blind patient shows decrescent as the age decrease. 4. The rate of the etiology of the blind eye; Trauma (23.02%), Eye disease (13.03%). Prenatal influences (7.20%). Systemic disease (5.59%), Tumor (0.77%), and unknown etiology (50.38%). 5. The rate of the site of the blind eye; Lens (32.90%). cornea (17.25%), retina (13.09%), optic nerve (8.86%). and uveal tract (3.69%). 6. The rate of the blind eye disease; Cataract (32.48%). corneal opacity (16.89%), optic nerve atrophy (7.20%), degeneration of the retina (7.08%), glaucoma (6.19%), phthisis bulbi (5.65%), anophthalmos (3.45%), uveitis (3.27%), and retinal detachment (3.21%). 7. The rate of the blind eye by visual acuity; Absolute blindness and visual acuity between 4/200 or above and less than 10/200 (19.2%), hand movement (19.0%). finger count/1m or less (18.6%). light perception only (16.5%), and visual acuity between 10/200 or above and less than 20/200 (4.5%). 8. Aside from absolute blindness (negative light perception), the causes of the blindness were the diseases of the lens, the cornea, and the retina. The prevalence of blindness due to the diseases of the cornea or optic nerve was the highest below the age of 20, and that due to lens diseases the highest over 41 year old.
Adult ; Age Distribution ; Anophthalmos ; Atrophy ; Blindness ; Cataract ; Cornea ; Corneal Opacity ; Educational Status ; Eye Diseases ; Female ; Fingers ; Glaucoma ; Hand ; Humans ; Korea ; Lens Diseases ; Male ; Onchocerciasis ; Optic Nerve ; Prevalence ; Retina ; Retinal Detachment ; Telescopes ; Trachoma ; Uveitis ; Visual Acuity ; Xerophthalmia

BACKGROUND: Chlamydia trachomatis (C. trachomatis) is an obligatory intracellular parasite which causes trachoma, inclusion conjunctivitis, pneumonia in infants, nongonococcal urethritis, epididymitis, cervicitis, and salpingitis. Salpingitis frequently produces tubal damage and infertility. The micro-immunofluorecence (MIF) test is the standard method for chlamydial serology and is highly sensitive and specific. This study aimed to evaluate the prevalence of C. trachomatis antibodies in healthy individuals and patients with various diseases as well as the clinical value of chlamydial serology by MIF testing. METHODS: A total of 692 serum samples were collected. Of these, 388 samples were obtained from healthy individuals (male 209, female 179). Cord blood samples were collected from 38 healthy babies. Serum samples of 53 female patients with infertility due to PID (group 1), 107 patients with respiratory diseases (group 2; pneumonia, bronchitis, etc.), and 106 patients with cardiovascular diseases (group 3; angina pectoris, acute myocardial infarction, etc.) who were admitted to Hanyang University Hospital from March 1995 to June 1998 were enrolled in this study. Serological diagnosis of a previous infection was made when IgG antibody titers to C. trachomatis were 1:32 or higher. A single titer of antibody of > or =1:512 for IgG or > or =1:16 for IgM was considered to indicate a recent infection. RESULTS: The IgG antibody detection rate in healthy individuals was 27%, broken down by age as follows: < or =10 year old, 36%; 11 to 20 years old, 17%; 21 to 30 years old, 28%; 31 to 40 years old, 36%; 41 to 50 years old, 25%; 51 to 60 years old, 26%; > or =61 years old, 24%. For cord blood, the antibody was detected in 29% of the samples. There were 1 case (0.3%) of recent infection with C. trachomatis by IgG, and 6 cases (1.5%) for IgM. The incidence of IgG antibodies to C. trachomatis in the disease group was 70%, 28%, and 19% for group 1, group 2, and group 3, respectively. There were 3 cases of recent infection detected by IgG and 4 cases by IgM in group 1. Recent infection with C. trachomatis was detected by IgG in 1 case of group 2 and by IgM in another case of group 3. CONCLUSIONS: In healthy individuals, the prevalence of antibodies to C. trachomatis was highest in those between the ages of 21-40 years. Patients with infertility due to PID showed a significantly higher positive rate (P=0.000 by Chi-square test) and more cases of recent infection to C. trachomatis than others. The results suggest that a positive chlamydial serology indicates a higher risk for infertility due to PID.
Adult ; Angina Pectoris ; Antibodies ; Bronchitis ; Cardiovascular Diseases ; Chlamydia trachomatis* ; Chlamydia* ; Conjunctivitis, Inclusion ; Diagnosis ; Epididymitis ; Female ; Fetal Blood ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Incidence ; Infant ; Infertility ; Male ; Middle Aged ; Myocardial Infarction ; Parasites ; Pneumonia ; Prevalence ; Salpingitis ; Serologic Tests* ; Trachoma ; Urethritis ; Uterine Cervicitis ; Young Adult