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Contact lens management in a late-stage trachoma and concurrent severe dry-eye: A case report

Published:April 20, 2020DOI:https://doi.org/10.1016/j.clae.2020.03.017
      Trachoma is a bilateral, chronic, and recurrent keratoconjunctivitis, following infection by the bacterium Chlamydia trachomatis, which leads to painful corneal abrasion and profuse modifications of the ocular surface, eventually causing blindness. It is considered accountable for the visual impairment of about 2.2 million people worldwide, of whom 1.2 million are irreversibly blind, and is estimated to be endemic in more than fifty countries. [
      • WHO
      Global WHO alliance for the elimination of blinding trachoma.
      ] Clinical findings of this disease include involutions of the peripheral cornea due to intense follicular conjunctivitis (Herbert pits), thickening and papillary hypertrophy of the upper tarsal conjunctiva with the presence of thick white, fibrotic bands (Arlt´s line), trichiasis and severe dry eye [
      • Satpathy G.
      • Behera H.S.
      • Ahmed N.H.
      Chlamydial eye infections: current perspectives.
      ,
      • Mohammadpour M.
      • Abrishami M.
      • Masoumi A.
      • Hashemi H.
      Trachoma: past, present and future.
      ] Corneal changes are the hallmark of the final blinding stage which embraces the clinical triad of pannus, epithelial vascularisation and infiltration [
      • Courtright P.
      • Sheppard J.
      • Schachter J.
      • Said M.E.
      • Dawson C.R.
      Trachoma and blindness in the Nile Delta: current patterns and projections for the future in the rural Egyptian population.
      ].
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