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More severe manifestations, such as trichiasis, typically occur in adulthood after multiple untreated infections.

Trichiasis is present when turned-in eyelashes scratch the eyeball – a debilitatingly painful condition that may lead to progressive and irreversible visual impairment.

TRICHIASIS, the last stage of an infection called trachoma, rarely hits the headlines.

Here in the remote village of N'Korobougou, in the western region of Koulikoro, Boubacar Fomba diagnoses a 68-year-old woman with trichiasis, the advanced stage of trachoma, where the infection has become so bad that the eyelashes have turned inwards, painfully scratching the eyeball with every blink.

Dr Alemayehu has trained a team of local health workers to perform trichiasis surgery in their community.