01779nas a2200301   4500000000100000008004100001260001700042653001000059653002600069653002100095653003000116653002200146653001100168653002500179653000900204653002500213653001100238653002100249653003000270100001700300700001400317700001200331245012100343300001000464490000700474520098200481022001401463       2008                            d  c2008 Sep-Oct10aAdult10aAnti-Bacterial Agents10aErythema Nodosum10aEye Infections, Bacterial10aFollow-Up Studies10aHumans10aLeprosy, lepromatous10aMale10aRupture, Spontaneous10aSclera10aScleral Diseases10aSeverity of Illness Index1 aRathinam S R1 aKhazaei H1 aJob C K00aHistopathological study of ocular erythema nodosum leprosum and post-therapeutic scleral perforation: a case report.  a417-90 v563 a<p>Leprosy is a chronic granulomatous disease caused by Mycobacterium leprae , clinically present either as tuberculoid, borderline or lepromatous type. Erythema nodosum leprosum (ENL) is an acute humoral response in the chronic course of lepromatous leprosy. Although very severe ENL reactions are known in systemic leprosy, such severity is rare in ocular tissues. A leprosy uveitis patient suffered from a severe form of post-therapeutic ENL reaction which resulted in perforation of the globe at the site of preexisting subconjunctival leproma. Painful blind eye was enucleated. Histopathological study revealed infiltration of numerous polymorphs and macrophages packed with acid-fast bacilli in the conjunctiva, cornea, ciliary body, ora serrata and sclera. A profuse influx of neutrophils on a background of macrophages packed with M. leprae confirmed the ocular ENL reaction. This case is reported to alert the ophthalmologists to a rare ocular complication of ENL.</p>  a0301-4738