Leprosy of the eye-a general outline
Ocular complications from leprosy (Hansen's disease) seriously threaten a patient's quality of life. The eye (the anterior segment structures) may be infiltrated and damaged by the mycobacteria directly; may suffer damage from inflammation (Type II reaction), and be damaged as a result of changes in the extraocular structures. These are fe atures of the disease at or near the lepromatous end of the spectrum. In addition to direct damage, the eye in about 15-20% of patients irrespective of their
... respective of their disease type, is subject to abnormal exposure due to nerve damage. This may be motor (c. 7) causing lagophthalmos, or sensory (terminal branches of ophthalmic division of C.5) causing corneal hypaesthesia. Secondary infection by other pathogens complicates the damage initiated by dryness and trauma. The patient most at risk is the one with active, long-standing lepromatous disease. He/she will possibly have diminished pain sensitivity. Symptoms will be unreliable. Routine objective examination of such patients becomes mandatory. Fortunately, most of the significant pathology is visible with the help of relatively unsophisticated instruments. A useful examination may be done in 2 or 3 minutes once the routine has become established. An outline of pathophysiology, diagnosis and management of the main fe atures of ocular leprosy have been presented in this article. Its aim has been to help the physician or other health worker to assume responsibility for the primary eye care of their leprosy patients and thus reduce the possibility of blindness. Loss of sensation of the extremities is a serious handicap to any individual. Blindness superimposes an intolerable burden. Leprosy is a disease which causes disability by affecting hands, fe et and eyes. The purpose of this paper is to give an overall perspective on the effects of leprosy on the eye in a logical outline form and to indicate in a broad outline form what can go wrong, how to recognize it and how to manage the problem. Further reading and consultations with ophthalmologists are highly recommended in order to get a working knowledge of leprosy of the eye.