Overview
Trachomatous pannus refers to the fibrotic changes and ingrowth of eyelashes into the ocular surface due to chronic trachomatous inflammation, often leading to trichiasis (inward-turning lashes). 1Diagnosis
Clinical Grading: Trichiasis severity is typically graded to guide surgical intervention 2.
Evaluation: Includes assessment of eyelid margin and lash misdirection 2.Management
Primary Treatment: Bilamellar tarsal rotation (BTR) surgery is a first-line intervention for trichiasis 2.
Surgeon Expertise: Surgery outcomes are comparable between ophthalmologists and integrated eye care workers (IECWs) 2.
Recurrent Cases: Laser photocoagulation can be considered for recurrent trichiasis, targeting diseased follicles 3.Special Populations
No Specific Guidelines: Abstracts do not provide specific management recommendations for pregnancy, pediatrics, elderly, or comorbidities 123.Key Recommendations
Perform bilamellar tarsal rotation surgery for trachomatous trichiasis, with outcomes comparable between ophthalmologists and IECWs (Evidence: Strong 2).
Consider laser photocoagulation for recurrent trichiasis cases showing satisfactory results in short-term follow-up (Evidence: Moderate 3).
Utilize a standardized grading system to assess trichiasis severity for surgical planning (Evidence: Expert opinion 2).References
1 Balantrapu TV, Hoare PJ. The International Agency for the Prevention of Blindness (IAPB) Launches Essential Equipment List for Screening and Surgery for Trachomatous Trichiasis. Ophthalmic epidemiology 2015. link
2 Alemayehu W, Melese M, Bejiga A, Worku A, Kebede W, Fantaye D. Surgery for trichiasis by ophthalmologists versus integrated eye care workers: a randomized trial. Ophthalmology 2004. link
3 Berry J. Recurrent trichiasis: treatment with laser photocoagulation. Ophthalmic surgery 1979. link