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Although individuals with trachoma may occasionally lose vision from pannus (a superficial fibrovasular proliferation) over the pupil, a more frequent cause of blindness is from a corneal ulcer caused by superinfection with a bacteria or a fungus. These ulcers frequently leave a corneal scar over the pupil and result in markedly decreased vision. People with cicatricial trachoma are at a higher risk for corneal ulcers for several reasons : dry eye from scarred tear glands, recurrent dacryocystitis from scarred tear ducts and decreased mucin production because of decreased conjunctival goblet cells. However, the most visible risk factor for corneal ulcers and blindness is trichiasis. Bowman et al. have shown that trichiasis is a 8-fold risk factor for blindness in trachoma (Bowman et al., 2001).

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Chapitre 9. How can the rate of avoidable blindness through treatment of trichiasis be evaluated?[Comment évaluer le taux de cécité évitable par cure de trichiasis ?]