MacCallan’s Classification of Trachoma

Stage 1 Stage 2 Stage 3 Stage 4

(T I) (T II) (T III) (T IV)
T IIa  mature follicles
 Large
Immature follicles  Pinkish 1. Patches of fibrosis
 Small  Raised above the surface affecting upper palpebral
 Grayish  Expressible conjunctiva & a dense Complete healing, no
Appearance
 Not raised above the T IIb  papillae white line at sulcus follicles nor papillae (as T III)
surface  Soft subtarsalis (Arlet’s line)
 Not expressible  Pinkish red 2. PTDs & PTCs
 Finger-like
 Narrow topped
Cellular infiltration
surrounding the invading 1. Follicles enlarge and 1. Degeneration occurs in
Patient becomes not
organism leading to undergo central necrosis conjunctival crypts in
infective
formation of aggregations of 2. Infiltration increases between papillae (PTDs)
Pathology (no inclusion bodies in
lymphocytes and around a core of blood 2. Calcification may occur in
conjunctival scrapings
surrounded by giant vessels covered by these degenerated areas
stained by Giemsa stain)
multinucleated cells epithelium  papillae (PTCs)
(Leber’s cells)