Mandibular trismus is a rare finding but may be present with larger swellings. Dysphagia may also be present in some cases. Fever may also be noted, whilst spiking temperatures may be suggestive of an abscess formation. Chronic recurrent sialadenitis
The occurrence of chronic recurrent episodes may be due to underlying Sjogrens syndrome or ductal abnormalities. Prodrome of tingling in the gland preceding pain and swelling may be reported in such cases. Chronic sclerosing sialadenitis
Typically presents unilaterally in submandibular gland that cannot be differentiated clinically from a neoplasm, with pain an inconsistent finding. Obstructive sialadenitis
Formation of stones in glandular ducts (sialoliths) can result in the development of obstructive sialadenitis. There may be a history of abrupt episodic swelling of the parotid or submandibular gland which is usually painful. These episodes typically occur around meal times, lasting 2 – 3 hours and gradually subsides. Autoimmune sialadenitis
Characterised by persistent, asymptomatic bilateral swelling of parotid glands, and may represent as a manifestation of more widespread systemic disease. Dry eyes and dry mouth are commonly present and may be indicative of concomitant connective tissue disease (e.g. SLE, RA, or scleroderma). Oral candidiasis may also be present. Common key diagnostic factors
1. Fever – may present with an acute infective sialadenitis or autoimmune aetiology suggestive of an infection or inflammation. 2. Pain and dysphagia (ie. difficulty swallowing) – usually unilateral affecting the parotid or submandibular regions, with worse pain during eating and swallowing. 3. Facial swelling – usually unilaterally and affecting parotid region, under the tongue, or below the jaw.
Antibiotic treatment reduces the risk of active trachoma in individuals infected with chlamydial trachomatis. Surgery
For individuals with trichiasis, a bilamellar tarsal rotation procedure is warranted to direct the lashes away from the globe. Evidence suggests that use of a lid clamp and absorbable sutures would result in reduced lid contour abnormalities and granuloma formulation after surgery. Early intervention is beneficial as the rate of recurrence is higher in more advanced disease. Lifestyle measures
The WHO-recommended SAFE strategy includes:

Surgery to correct advanced stages of the disease
Antibiotics to treat active infection, using azithromycin
Facial cleanliness to reduce disease transmission
Environmental change to increase access to clean water and improved sanitationChildren with visible nasal discharge, discharge from the eyes, or flies on their faces are at least twice as likely to have active trachoma as children with clean faces. Intensive community-based health education programs to promote face-washing can reduce the rates of active trachoma, especially intense trachoma. If an individual is already infected, washing ones face is encouraged, especially a child,  to prevent reinfection. Some evidence shows that washing the face combined with topical tetracycline might be more effective in reducing severe trachoma compared to topical tetracycline alone. The same trial found no statistical benefit of eye washing alone or in combination with tetracycline eye drops in reducing follicular trachoma amongst children. Prognosis
If not treated properly with oral antibiotics, the symptoms may escalate and cause blindness, which is the result of ulceration and consequent scarring of the cornea. Surgery may also be necessary to fix eyelid deformities.