During a school survey in a rural district, an 8-year-old girl shows dense follicles on the upper tarsal conjunctiva with inflammatory thickening that obscures half of the normal deep tarsal vessels. There is no visible scar. According to the WHO simplified grading system, what stage is this?

• A Trachomatous inflammation, follicular (TF)
• B Trachomatous inflammation, intense (TI) ✓
• C Both TF and TI should be recorded together
• D Trachomatous scarring (TS)

Explanation

Inflammatory thickening of the upper tarsal conjunctiva that obscures at least half of the deep tarsal vessels defines TI, even when follicles coexist. Under the WHO simplified system, TF and TI are mutually exclusive grades: the examiner records TI when vessel obscuration meets the threshold, because TI supersedes TF in severity. TS requires easily visible scarring of the tarsal conjunctiva, which this child lacks. District-level TI above 5% triggers mass antibiotic distribution.

Reference: Parsons' Diseases of the Eye, 23rd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.