A clinical study of ocular manifestations in leprosy

Leprosy (Hansen disease) is a chronic infectious disease which affects the anterior segment of the eye. These are about 11 million cases of leprosy throughout the world and about 1/3rd have complications related to the eye. OBJECTIVES: Objective of this clinical study is to study the distribution of ocular involvement in patients with leprosy under various parameters like age, sex, duration, the different modes of ocular manifestations, and to identify and appropriately manage potentially sight threatening lesions. METHODS: In this clinical study, 50 patients with leprosy were examined to study the ocular involvement in leprosy. Detailed history taken and thorough clinical examination done, which was recorded on a predesigned proforma. Potentially sight threatening lesions identified and were appropriately managed conservatively or surgically. RESULTS: Ocular involvement was seen in 58 % of the patients with leprosy, among whom 72.4% had potentially sight threatening lesions. Most common ocular manifestation observed was superciliary madarosis (48 %).The other predominant potentially sight threatening lesions were lagophthalmos (35%), corneal hypoesthesia (28%), exposure keratitis (21%), corneal opacity (17%), cataract (17%), anterior uveitis (7%). Visual impairment was seen in 48.28%. No case of blindness was seen. Ocular manifestation was seen in the patients, despite all the patients being treated with systemic anti – leprosy drugs. CONCLUSIONS: The eye is involved in various forms in all the types of leprosy. The risk of ocular complication increases with increased duration of disease and with lepra reactions. Since ocular involvement can be seen even after completion of anti-leprosy treatment, the need for screening and periodic eye examination of all the patients with leprosy should be emphasized, for early identification of potentially sight threatening lesions which can be easily treated.