A survey of trachoma: The histopathology and the mechanism of progressive cicatrization of eyelid tissues

The aim of this study is to demonstrate the spectrum of conditions encompas sed by the term 'trachomatous cicatrization of eyelid tissue', to discuss t he mechanisms of scar tissue formation and to describe sequelae in this pot entially blinding condition. Specimens of eyelid tissues were taken from 27 upper eyelids of 21 patients with entropion who underwent surgical procedu res and 2 post-mortem upper eyelids with severe trachomatous entropion, Upp er palpebral conjunctival swabs and biopsy specimens were taken from 5 pati ents with active trachoma and they were examined by fluorescence microscopy and routine histopathological methods. Conjunctival impression cytology sa mples were collected in all patients, In specimens taken from patients with active trachoma the inflammatory infiltrate was organized as lymphoid foll icles in the underlying stroma and impression cytology showed cytoplasm ic elementary bodies. In specimens taken from patients with scarring trachoma light microscopy studies showed subepithelial fibrous membrane formation, s quamous metaplasia and loss of goblet cells, pseudogland formation in conju nctiva, degeneration of orbicularis oculi muscle fibres, subepithelial vasc ular dilatation, localized perivascular amyloidosis and subepithelial lymph ocytic infiltration, Accessory lachrymal glands and the ducts of glands wer e compromised by subepithelial infiltration and scarring, The contraction o f the subepithelial fibrous tissue formed by collagen fibres a nd anterior surface drying a re the main factors contributing to the chronic cicatrizat ion and entropion formation. Copyright (C) 2000 S. Karger AG, Basel.