Trachoma is an ancient disease that has survived until the present day and represents the most common cause of infectious blindness globally. This study reviews the main Greek medical sources of the period from the 1st to 7th century AD and presents the medical knowledge relating to trachoma, including its definition, clinical features, diagnosis, complications, and treatment. It was widely accepted that trachoma was a disease of the palpebral conjunctiva, and the different stages of trachoma were described in detail. However, it is unclear whether the stages of trichiasis and pannus were identified as trachoma complications. The extensive references to the treatment of trachoma during the Byzantine period provide a strong argument for the case that trachoma was one of the most serious and common eye diseases. Both surgical and pharmaceutical treatments were often applied at the same time. Occasionally, surgical treatment could be rather dramatic, involving the use of stiff fig leaves or a chisel. Nevertheless, the prognosis was always poor, and the disease developed over the years until it threatened the cornea.