The appearance of trachoma is one of the symptoms of trachoma. Trachoma is a chronic infectious conjunctival keratitis caused by Chlamydia and is one of the most blinding eye diseases. Trachoma is named after the rough and uneven appearance of the conjunctival surface, which resembles sand grains. In the early stages of the disease process, there is infiltration of the conjunctiva, such as papillae and follicular hyperplasia, and corneal vascular opacification; in the late stages, scarring of the affected lid conjunctiva leads to inversion of the eyelid, which aggravates the damage to the cornea and can seriously affect vision and even cause blindness. What are the symptoms that are easily confused with it? 1. Grayish white film on the lid conjunctiva Grayish white film on the lid conjunctiva can be seen in all types of conjunctivitis and is usually caused by infectious factors. It is usually caused by an infection, due to neovascularization. Leakage, bleeding, and eventually scarring, resulting in a permanent mechanized membrane. 2. Hard, flat papillae of the lid conjunctiva The clinical manifestations of springtime khat conjunctivitis are caused by an initial, intense congestion of the lid conjunctiva, followed by the development of many hard, flat papillae of varying sizes on the upper lid conjunctiva, resembling paved pebbles. The fissure between the papillae is light blue, and the surface of the papillae appears cloudy like cow’s milk. The secretions are small, sticky, and filamentous, and on smear examination, an increase in eosinophils is seen. If there are lesions in the lower lid conjunctiva, the papillae are small and few, and less prominent than those in the upper lid conjunctiva. Vernal conjunctivitis is an allergic disease that is highly seasonal and often affects both eyes. It develops in the spring when it is warm and disappears in the late fall when it is cold. The disease recurs every year, and in mild cases it does not recur after 3 to 4 years, while in severe cases it can recur continuously for more than 10 years. The disease is characterized by itchy eyes, large, flat papillae on the lid conjunctiva and colloid hyperplasia of the conjunctiva near the corneal limbus, and secretions with large numbers of eosinophils. 3. Giant papillae of the lid conjunctiva Giant papillae of the lid conjunctiva due to hyperplasia of the lid conjunctiva caused by diseases such as spring keratoconjunctivitis are one of the clinical manifestations of spring conjunctivitis. 4. Congestion of the lid conjunctiva reveals a yellow pus mass The lid gland in an inflamed state is surrounded by firm lid tissue. The surface of the congested lid conjunctiva often reveals a yellow pus mass that may rupture on its own and drain into the conjunctival sac. This is one of the clinical manifestations of mydriasis. A mydriasis, commonly known as a needle’s eye, is an acute purulent inflammation of the sebaceous or lid gland near the eyelash follicle. There are two types of glands in the eyelid: the sebaceous gland at the root of the eyelashes, which opens into the hair follicle, and the lid gland, which is buried in the lid plate near the conjunctival surface and opens into the lid margin. The other is called the lid gland, which is buried near the conjunctival surface and opens at the lid margin. The bacteria that cause mydriasis are mostly Staphylococcus aureus, so mydriasis is mostly a purulent inflammatory disease.