@article{8661,
  keywords = {Adolescent, Adult, Aged, Aged, 80 and over, Blindness, Cataract, Child, Chloroquine, Corneal Diseases, Cross-Sectional Studies, Drug Therapy, Combination, Endemic Diseases, Eye Infections, Bacterial, Female, Glaucoma, Glucocorticoids, Humans, India, Intraocular Pressure, Leprostatic Agents, leprosy, Male, Middle Aged, Prevalence, Refraction, Ocular, Rural Population, Uveitis, Visual Acuity, Young Adult},
  author = {Parikh R and Thomas S and Muliyil J and Parikh S and Thomas R},
  title = {Ocular manifestation in treated multibacillary Hansen's disease.},
  abstract = {<p><b>PURPOSE: </b>To report the prevalence of ocular morbidity in patients with treated multibacillary Hansen's disease (HD) using modern ophthalmic diagnostic techniques in a rural community endemic for HD.</p><p><b>DESIGN: </b>Cross-sectional, observation study.</p><p><b>PARTICIPANTS: </b>All patients with multibacillary HD who had completed their multidrug therapy and who resided in 4 defined geographical areas in Vellore, Tamil Nadu, India.</p><p><b>METHODS: </b>All participants underwent a complete eye examination that included slit-lamp examination, esthesiometry, gonioscopy, applanation tonometry, and dilated fundus examination, including a stereobiomicroscopic examination of the fundus at an ophthalmic center set up for that purpose. Glaucoma suspects underwent automated perimetry using a Humphrey Field Analyzer (Humphrey Instruments, San Leandro, CA).</p><p><b>MAIN OUTCOME MEASURES: </b>The prevalence of various ocular disease parameters were reported as mean value with 95% confidence interval. The difference of disease prevalence between various leprosy groups was compared using an unpaired t test. The association between eye symptoms and potentially sight-threatening complications was analyzed using the chi-square test.</p><p><b>RESULTS: </b>Three hundred eighty-six of the 446 patients with multibacillary HD residing in the defined areas were evaluated. Four patients (1.04%; 95% confidence interval [CI], 0.0%-2.0%) were bilaterally blind; 33 (8.55%; 95% CI, 5.8%-11.3%) had unilateral blindness. Mean intraocular pressure was 12 mmHg (standard deviation, 4.1 mmHg), and prevalence of glaucoma was 3.6% (95% CI, 1.8%-5.5%). Potentially sight-threatening (PST) pathologic features (corneal anesthesia, lagophthalmos, uveitis, scleritis, and advanced glaucoma) were present in 10.4% (95% CI, 7.4%-13.4%) of patients. Significant cataracts occurred 3 times more frequently in those with polar lepromatous leprosy. The odds ratio for PST pathology in the presence of patient-reported symptoms (pain, redness, inability to close eye, burning, and irritation) was 2.9 (95% CI, 1.34-6.26).</p><p><b>CONCLUSIONS: </b>Patients who have completed treatment for multibacillary HD continue to have significant ocular morbidity. A history of specific eye symptoms can be the basis for referral by field staff.</p>},
  year = {2009},
  journal = {Ophthalmology},
  volume = {116},
  pages = {2051-7.e1},
  month = {2009 Nov},
  issn = {1549-4713},
  doi = {10.1016/j.ophtha.2009.04.021},
  language = {eng},
}