Trachoma: the forgotten cause of blindness.

Trachoma, the second leading cause of blindness world wide, continues to be hyperendemic in many areas of Africa, Asia, and the Middle East. Caused by an ocular infection with Chlamydia trachomatis, this chronic conjunctivitis results in more blindness than any other infectious eye disease. Once endemic in most countries, trachoma has largely disappeared from Europe and the Americas. Because of its disappearance from developed countries and its endemicity in the poorest of communities, trachoma has been largely forgotten as a public health issue. Communities with trachoma are often those with the fewest resources to take on health issues, and trachoma strikes the most vulnerable members of those communities—women and children. Second only to cataract as the leading cause of blindness, trachoma affects an estimated 300-500 million people of whom 5-7 million are blind (1). In the last 10 years, there have been considerable advances in our understanding of the epidemiology and approaches to trachoma control that have major ramifications for public health measures against this disease. In this review, we summarize the characteristics of trachoma, the epidemiology and risk factors for the disease, and promising approaches to control strategies. The strides made in research on trachoma clearly warrant a reprioritization of this forgotten disease.