Trachoma: A Blinding Scourge from the Bronze Age to the Twenty‐First Century:Trachoma: A Blinding Scourge from the Bronze Age to the Twenty‐First Century

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Trachoma: A Blinding Scourge from the Bronze Age to the Twenty-First Century is a handsome and generously illustrated volume about this ancient disease by Hugh Taylor, Professor of Indigenous Eye Health at the University of Melbourne. The book covers the historical record, clinical description, epidemiology, chlamydial microbiology, clinical and laboratory diagnosis, and pathogenesis of trachoma, as well as the current efforts to eliminate blindness caused by the disease. At one level, this book reflects Professor Taylor's personal experience with trachoma, with extensive accounts of his own field and laboratory studies. He also includes descriptions of the persistent trachoma problem among Australian Aborigines. There are 2 chapters on the history of trachoma: the first describes the period from antiquity to the spread of “ophthalmia aegyptiaca” in the early 19th century, and the second describes the status of trachoma prior to World War 2. The chapter on clinical diagnosis follows the tortuous evolution of descriptive systems of the disease as seen on the inner surface of the upper lid. The 1981 World Health Organization (WHO) system was intended to identify only those cases due to Chlamydia trachomatis and continues to be used in some research studies. The simplified 1987 WHO system was intended for use by health aides with minimal training. This simplified system is now used in most control programs to determine the prevalence of disease and to judge the effect of treatment and the need to continue antibiotic therapy. This chapter also mentions the other types of bacterial conjunctivitis commonly associated with active trachoma, including conjunctivitis due to Haemophilus influenza (including biotype III, which was once known as Haemophilus egyptius), Moraxella species, and pneumococcus. Taylor describes the high prevalence of these bacterial ocular pathogens but does not attribute any role for them in the clinical evolution of trachoma separate from that caused by the chlamydial infection.