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Antibiotic Effective Against Leading Cause of Blindness Throughout the World

Armen Hareyan's picture

Treating Trichiasis

A clinical trial funded by the National Eye Institute (NEI), part of the National Institutes of Health (NIH), has concluded that a single dose of azithromycin taken by mouth after surgery reduces by one-third the recurrence of a vision-threatening eyelid condition called trichiasis. This is in contrast to the usual six-week regimen of tetracycline ointment applied directly to the eye. This study is published in the March 2006 issue of Archives of Ophthalmology.

"This study illustrates the importance of NIH clinical trials to find treatments for diseases that affect people throughout the world," said Elias A. Zerhouni, M.D., director of the NIH. "When we consider that an estimated 11 million people worldwide develop trichiasis every year, we see the impact that the findings of this study may have in preventing future vision loss."

Trichiasis is a condition in which the eyelid turns inward and eyelashes rub against the eye, resulting in corneal scarring and loss of vision. It results from trachoma, an eye infection that is the leading preventable cause of blindness in the world. It is spread through contact with flies and other insects, clothing or household items that harbor the bacterium, or infected people.

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Trachoma occurs in poor, overcrowded communities that have little access to clean water, waste treatment facilities, or health care. These communities are located mainly in Africa, the Middle East, Asia, Australia and some areas of Latin America.

The World Health Organization (WHO) previously endorsed a multi-faceted strategy to control trachoma, including surgery for trichiasis and application of tetracycline after surgery.

In this study, called Surgery for Trichiasis, Antibiotics to Prevent Recurrence (STAR), eye infection with the bacterium that causes trachoma was present in 19 percent of the adults with trichiasis in Wolayta Zone, Ethiopia, the location of the clinical trial. More than 77 percent of the patients were women, who have four times the rate of trichiasis than men. Women often contract trachoma repeatedly by taking care of infected children.

"This clinical trial was relatively inexpensive to conduct, and produced results that may well save the vision of millions of people," said Paul A. Sieving, M.D., Ph.D., director of vision research at NIH. "We look forward to supporting future trials to treat blinding eye diseases worldwide."

"The simple surgical repair of the eyelid to prevent blindness has been plagued by high rates of recurrence of trichiasis