Subtarsal fibrosis

Subtarsal fibrosis in trachoma

Corneal opacities in trachoma
Trachoma is uncommon in the UK. However, in the examination you may be given patients who acquire the disease in their 
home countries. Always ask to examine the undersurface of the upper lid if you found upper lid entropion and/or diffuse 
corneal opacities especially if the patients were non-white.

There are diffuse corneal opacities (sometimes with vascularization) in both eyes and/or bilateral upper entropion. The 
inferior fornix is deep and there are no symblepharons (the presence of symblepharon should make one consider ocular 
cicatricial pemphigoid, Steven-Johnson's syndrome or chemical burnt injuries). On everting the eyelids, there are subtarsal 

Other features that may suggest trachoma:

  • micropannus in the superior cornea
  • pits at the limbus (Herbert's pits which results from necrosis of the follicles)


1. How does trachoma cause blindness?

2. What are the differences between trachoma and adult inclusion conjunctivitis?

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