| Objective: To study the reasons for trachoma diagnosed improperly, so as to diagnose and treat properly trachoma and other conjunctival diseases, which provided evidences for clinical medicine treatment. Methods: 103 patients, who had once been diagnosed for trachoma and had accepted medicine treatment, were randomly collected and carefully examined through slit-lamp biomicroscope. Items of examination included papillae, follicle and pannus corneae in palpebral, fornical and cornea. Conjunctival scrapings of 87 patients were respectively dyed with Giemsa, Wright and Gram stains and detected for cytorrhyctes, cell types and bacteria, including shapes and types of bacteria. It was suspectd that 20 patients catched trachomas. Their signs were conjunctival congestion, unclear blood vessel, hyperplastic papillae or follicle without scar, pannus corneae and cytorrhyctes in conjunctival scrapings. FQ -PCR method was used to detect specific nucleate of chlamydia trachomatis. Schirmer ? experiment was used to test 20 cases with clear symptoms of dye eye. All patients were definitely diagnosed according to above results of clinical and laboratory examinations and the criteria of trachoma , other conjunctival and ocular diseases. Results:1. 103 patients who had been diagnosed for trachoma were investigated. The findings suggested that 40 cases were specifically diagnosed for trachomas that agreed with primary diagnoses and 63 cases were made their wrong diagnoses. 4o cases included 5 in active phase, 19 in cataplasia phase and 16 in scarring phase. Cases above 40 age accounted for 82.5%. Other 63 cases included 33 with chronic catarral conjunctivitis, 8 with vernal conjunctivitis, 10 with follicular conjunctivitis, 2 with allergic conjunctivitis, 6 with giant papillary conjunctivitis, 2 with dry eye syndrome and 2 with meibomian gland dysfunction. Patients specifically diagnosed for trachomas differed from patients misdiagnosded for trachomas that were truly other conjunctival and ocular diseases in figure. It was seen that other conjunctival diseases were easely misdiagnosded for trachomas.2. 103 patients were from hospitals of different rank that were province hospital, municipality hospital, county hospital and district hospital. There were 36 patients from province hospitals, 18 of which were specifically diagnosed for trachomas once again and 18 of which had wrongly been diagnosed for trachomas. Misdiagnosis rate is 50%. There were 19 patients from municipality hospitals, 9 of which were specifically diagnosed for trachomas and 10 of which had wrongly been diagnosed. Misdiagnosis rate is 52.63%. There were 26 patients from county hospitals, 10 of which were specifically diagnosed for trachomas and 16 of which had wrongly been diagnosed. Misdiagnosis rate is 61.54%. There were 22 patients from district hospitals, 3 of which were specifically diagnosed for trachomas and 19 of which had wrongly been diagnosed. Misdiagnosis rate is 86.36%. Patients specifically diagnosed for trachomas and misdiagnosded for trachomas that were truly other conjunctival and ocular diseases vary from hospital to hospitals in figure and misdiagnosis rate. There were hight misdiagnosis rate in hospital of basic level.3. The relation between active disorder of trachoma and age indicated decrease in morbidity of trachoma with fall in age and in incidence rate of trachoma. Among 40 cases in trachoma , there was 1 case in ≤20 age group , 6 cases in 21~40 age group and 33 cases in>40 age group. Conlution: 1. Currently, there are many cases misdiagnosded for trachomas. There are 63 misdiagnosded among 103 patients diagnosed for trachoma and accepting medicine treatment and randomly collected in the investigation. Misdiagnosis rate is hightly 61.17%. Patients with typical trachomas are easely diagnosed by typical signs, but some patients in hospital of basic level are given clinical diagnoses through doctor,eyes without examination of slit-lamp biomicroscope. Sometimes differences between trachoma and other conjunctivitis are confused. Hyperplastic papillae and follicle are not special signs in trachoma, but comment disorder that any conjunctivitis will all produce. It is important to search for the cause of conjunctivitis associated with case history. Auxiliary examination will necessarily help diagnose disease. In addition, to further strengthen to know about trachoma in pathology, pathophysiology, clinical manifestation, diagnosis as well as antidiastole, and so on, and to identify essential differences between trachoma and other conjunctivitis will help diagnoses and treatments...
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