[On the spot treatment of active and inactive trachoma in lower Egypt]

In spite of WHO programmes with azithromycin therapy and prophylaxis of trachoma, active and inactive stages of trachoma have not yet lost their position as one of the leading causes of blindness worldwide. For underprivileged inhabitants a specially adapted catalogue of surgical procedures was selected and for the special purposes of on-the-spot surgery and follow-up with one, two or no further examinations or removal of suture material was adapted.

For 45 patients with trichiasis, trachoma scarring of upper and lower lids with entropium and different kinds of corneal damage, eight different surgical procedures with, in part, modifications were adopted.

By modifications of known surgical procedures with postoperative correction of lid position, the more precise marking of trichiasis lashes, preparation to their roots for epilation or cauterisation and for minimal measurements in follow-up, essentials were found for adaptation to this purpose and the best procedures identified.

Eight different surgical procedures for different scarring stages of trachoma and trichiasis including entropium at the upper and lower lids with cornea pannus led, by a selected adaptation to the particular purposes and situations, to an overall success rate of > 90 %. Visual acuity improvements in 50 % of the patients were recognised. The otherwise present threat of blindness in the further course could be avoided.