Ocular complications in patients with leprosy in Karigiri, South India

Abstract

Summary The examination of 143 leprosy patients revealed that 91 had ocular lesions attributable to leprosy and of these 13 were blind. The commonest lesion was madarosis and the commonest cause of blindness was chronic iritis (3 1 % of all blind patients). Lagophthalmos remains an important condition and fo und in 25% of patients while corneal lesions account for a large number of ocular problems in leprosy (exposure keratitis 31 %, interstitial keratitis 8%). Most affected is the 40--60 year, age group and most of the affected patients had long-term disease. Lepromatous patients were also encountered more frequently (70%) among the involved patients. A large number of patients also suffered from gross deformities (53%) and even more so amongst the blind (77%). This study does point out the importance of careful and regular examination of the eyes of leprosy patients by all involved with the care of these unfortunate people.As early as 1873, Hansen and Bull drew attention to the high incidence of ocular complications in leprosy in their book The leprous disease of the eye where they commented that there is no disease which so frequently gives rise to disorders of the eye as leprosy does.1 In spite of this early awareness there is still considerable ignorance of many aspects of the problem . Good studies of the subject are fe w and far between. Several prevalence surveys have been carried out but there is still no standard method of classifying the lesions and this makes their comparison difficult.The incidence of ocular leprosy is known to vary according to climate, sex, race, type of leprosy and skin pigmentation. One study2 has demonstrated a prevalence in Malaysia of 16· 3% while another has shown that 96% had ocular manifestations in Panama,3 both studies being amongst institutionalized patients.