Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomised Controlled Trial of Epilation Verses Immediate Surgery for the Management of Minor Trachomatous Trichiasis
Brief Summary: Trachoma is the leading infectious cause of blindness worldwide. Recurrent infection by Chlamydia trachomatis causes a gradual scarring process of the inner surface of the eyelid (conjunctiva) leading to in-turning of the eyelids (entropion) and lashes touching the eye (trichiasis). The rate of progression and the severity of disease are variable. Some people develop severe disease with extensive entropion and trichiasis, whilst others have a mild problem with only a few lashes touching the eye, which does not progress.

In more advanced cases there is a broad consensus that the entropion / trichiasis should be corrected by surgery. In mild cases (minor trichiasis: 1-5 lashes touching the eye) the optimal treatment is uncertain. Some advocate early surgery to turn the eyelid out for any individual with one or more lashes touching any part of the eye. Others consider this to be too early for surgical intervention, as surgery can have a high recurrence rate and complications can arise. Instead, they recommend that minor trichiasis can be managed by epilation (pulling out lashes with forceps). In many endemic regions the uptake of surgery is low, with many patients preferring to epilate for mild disease.

The primary purpose of this study is to compare the outcome of immediate surgery to regular epilation for the management of minor trichiasis. The epilation would be done by a person with good eyesight using proper epilation forceps.


Options:
A: Inclusion Criteria:

* Major trichiasis: more than 5 lashes touching the eye

Exclusion Criteria:

* Previous eyelid surgery
B: Inclusion Criteria:

* Presence of trichiasis:
* no previous report of trichiasis surgery in at least one eye with trichiasis:
* Agreement by at least one other family member accompanying the patient that, if the patient is randomized to the family-treatment arm, s/he also would be willing to receive antibiotic treatment
* Age 18 or older

Exclusion Criteria:

* other household members concurrently participating in the trial
* Self-reported pregnancy
* Documented allergy to tetracycline
* Plans to move out of the region within 1 year.
C: Inclusion Criteria:

* Presence of upper lid trichiasis: defined by at least one eyelash touching the globe of the eye or evidence of epilation
* No previous report of trichiasis surgery in at least one eye with trichiasis:

  * eyes with prior surgery are already at high risk due to the prior surgery, and their inclusion may decrease our ability to clearly evaluate our primary outcome
  * if unilateral surgery has been performed previously, only the eye without prior history of surgery will be in the study, even if both eyes require surgery
* Age 18 or older (in order to provide consent as an adult): the vast majority of trichiasis patients are aged 18 or older
* At time of enrollment, subjects must state their intention to remain in the area for two years to facilitate study follow-up

Exclusion Criteria:

* Absence of upper lid trichiasis
* Prior trichiasis surgery on both eyes
* Age 18 or younger
* Subjects who are transiently in the area
D: Inclusion Criteria:

* Minor trichiasis: 1 - 5 lashes touching the eye

Exclusion Criteria:

* Previous eyelid surgery.
* Patients with evidence of corneal damage (will be offered surgery).

Answer: D