Trachoma, the worlds leading cause of preventable blindness, is the subject of worldwide control efforts via the SAFE (Surgery, Antibiotic Treatment, Facial Cleanliness and Environmental Improvement) strategy. The “A” component of this strategy antibiotic treatment of the active disease has been supported through the large scale donation of millions of doses of the antibiotic azithromycin by its manufacturers, Pfizer, for distribution in trachoma endemic areas by the International Trachoma Initiative.¹ Azithromycin, as a single 20 mg/kg oral dose is effective against Chlamydia trachomatis infection.² In the field the diagnosis of active trachoma may be made simply by examining the surface of the everted upper eyelid for clinical signs of trachoma: lymphoid follicles and inflammatory thickening.³ Current recommendations …