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LETTER TO EDITOR
Year : 2002  |  Volume : 50  |  Issue : 4  |  Page : 355-356

Ocular involvement in leprosy



Correspondence Address:
Mahendra K Singhi


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Source of Support: None, Conflict of Interest: None


PMID: 12532508

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How to cite this article:
Singhi MK, Kacchawa D, Ghiya BC. Ocular involvement in leprosy. Indian J Ophthalmol 2002;50:355-6

How to cite this URL:
Singhi MK, Kacchawa D, Ghiya BC. Ocular involvement in leprosy. Indian J Ophthalmol [serial online] 2002 [cited 2020 Dec 4];50:355-6. Available from: https://www.ijo.in/text.asp?2002/50/4/355/14749



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  Dear Editor, Top


Ocular complications in leprosy are common and they usually lead to vision impairment or even blindness. Eye involvement in leprosy could result not only from the disease itself but also from reactions to the drugs used in the treatment. We studied 518 patients attending the Urban Leprosy Center, Department of Skin & VD, Dr. S.N. Medical College, Jodhpur. In this group of patients, 247 (47.6%) had lepromatous leprosy, 123 (23.3%) had tuberculoid leprosy and 148 (28.5%) had dimorphous leprosy. Both eyes (n = 1036) of the patients were examined in detail by an ophthalmologist. This included recording the visual acuity, and examinations of the adnexa (eyebrow, eyelashes, eyelids), pupil, lacrimal system, sclera and cornea. A total of 262 (50.5%) patients had involvement of one or both eyes.

In 247 patients with lepromatous leprosy, 136 (55%) had eye involvement; 76 (30.7%) bilateral and 60 (24.3%) patients unilateral. In 148 patients with dimorphous leprosy, 72 (48.6%) had eye involvement - 32 (21.6%) unilateral and 40 (55.5%) bilateral. In 123 patients with tuberculoid leprosy, 54 (43.9%) had eye involvement -46 (37.3%) unilateral and 8 (6.5%) bilateral.

Many patients exhibited more than one type of ocular pathology. It was observed that in lepromatous leprosy and dimorphous leprosy bilateral involvement was greater as compared to tuberculoid leprosy.

For the sake of convenience we divided ocular involvement into two categories: adnexal changes and bulb changes. The type of ocular involvement and its percentage in different types of leprosy is shown in the Table. The eyes were more frequently affected in lepromatous leprosy. Madrosis was the most common ocular adnexal change and the corneal changes were most common in ocular bulb changes. Lagopthalmos, often accompanied by ectropion, was probably the primary cause for the corneal changes.

Frequency of ocular involvement in leprosy is reported variably from as low as 6.3% to as high as 74.2%.[1-[3] This is perhaps related to the environment in addition to the health care facilities in the region. Jodhpur is known as the gateway of the Thar desert and intense heat and sandy environment prevails here throughout the year. These environmental factors contribute to the damage of these already anaesthetic eyes of leprosy patients. In our study we found that more than 50% patients had eye problems.

We wish to reemphasise that the eye must be examined carefully in every case of leprosy. Simple and timely measures can make a difference to a patient's life by preserving the vision.

 
  References Top

1.
Malla OK, Brandt F, Anten JGF. Ocular findings in leprosy patients in an institution in Nepal (Khokana). Br J Ophthal 1981;65:226-30.  Back to cited text no. 1
    
2.
Ticho U, Sira IB. Ocular leprosy in Malawi. Br J Ophthal 1970;54:107-12.  Back to cited text no. 2
[PUBMED]    
3.
Weerekoon L. Ocular leprosy in Ceylon. Br J Ophthal 1989;53:457-65.  Back to cited text no. 3
    



 
 
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