Ocular Manifestations of Leprosy Patients on Multidrug Therapy in a Teaching Hospital of South Karnataka

Abstract

BACKGROUND Leprosy is a chronic granulomatous infectious disease caused by Mycobacterium leprae. Several ocular manifestations occur before and during multi drug therapy (MDT) and they can continue to occur even after the completion in bacteriologically cured patients. Blindness is a catastrophic event that can occur by several mechanisms at any stage. We need to learn and recognise the early signs and symptoms of ocular complications, so that we can treat the patient early. We need to evaluate the pattern of ocular manifestation in leprosy patients on MDT (Multi Drug Therapy). METHODS A cross-sectional study was conducted over a duration of six months on diagnosed cases of leprosy and those cured from leprosy. Data was collected by clinical history with slit lamp examination, fundus examination, and laboratory investigation. RESULTS Total 30 patients were included in the study in which 13 patients were on MDT, 7 newly detected cases and 10 treated cases. 22 were males and 8 were females with male - female ratio of 2.75:1. Average age of presentation was 46 years with range from 18 - 80 years. 56 % had ocular manifestations in this study. Ocular lesions were more in cases who had leprosy for ≥ 16 years. Visual acuity ranged from 6 / 6 to PL + ve. Lagophthalmos was noted in 4 cases, cataract in 6 cases, exposure keratitis in 2, chalky white deposits on cornea in 2, spheroidal degeneration in 2, iris atrophy in 2, and pterygium in 2 cases. CONCLUSIONS Patients who completed treatment for MDT require periodic monitoring to detect ocular morbidity early and to prevent visual loss. KEYWORDS Leprosy, Multidrug Therapy, Exposure Keratitis, Lagophthalmos