The article is devoted to the study of the prerequisites and circumstances of the first trachomatous institute establishment in Russia, designed to stop the spread of a dangerous infectious eye disease in one of the key regions of the RSFSR the Republic of Tatarstan. The initial period of the spread of trachoma in the Russian Empire, dating back to the first quarter of the 19th century, is characterized, and the first steps in the study and treatment of trachoma in the Kazan province are defined. On the basis of archival documents, many of which were not previously introduced into scientific circulation, the authors analyze a significant layer of historical information that sheds light on a number of facts that have not been previously published or studied. The prerequisites that characterize the formation of the attitude of the Kazan scientific community to the need to organize the fight against a new spreading disease trachoma on a large scale, have been identified. For the first time, prosopographic data on the first leaders of the institute were clarified, it was convincingly proved that, contrary to popular belief, it was not V.V.Chirkovsky, but A.G.Agababov who became the first director of the Trachomatous Institute in Kazan. Materials on the circumstances and conditions of the actual opening of the trachomatous institute in 1922 are given. The features of the fight against trachoma in the period preceding the opening of the trachomatous institute, starting with the activities of E.V.Adamyuk, representatives of the Kazan Governorate and special medical commissions, ending with the formation of a specialized scientific and clinical infrastructure, are identified.