A review of the ophthalmic manifestations of leprosy.
Aim: To review the ocular and adnexal manifestations of leprosy.
Methods: Literature was obtained from internet search of various sites including Entrez PubMed, Google Scholar, Hinari, African Journals Online etc. Information was also obtained from textbooks, leprosy registries and dissertations of the Faculty of Ophthalmology, National Postgraduate Medical College of Nigeria.
Results: Leprosy is a chronic granulomatous disease of low grade infectivity in man caused by Mycobacterium leprae. It primarily affects the peripheral nervous system and secondarily involves the skin, eye, upper respiratory tract and testes. The causative organism is slow growing and has preference for cool temperature less than 37oC. Therefore its ophthalmic manifestations are more in the cooler ocular adnexa and anterior segment of the eye. Tuberculoid leprosy was the most common form of leprosy in Nigeria. Leprosy has the highest incidence of ocular involvement than any other infectious disease of man, usually leading to low vision or blindness. Sight threatening complications usually are cataract, lagophthalmos, corneal anaesthesia, exposure keratitis, corneal opacities, neuroparalytic keratitis and chronic uveitis. Ophthalmic manifestations include mdarosis, lagophthalmos which can be complicated by recurrent corneal ulceration, resulting in corneal scarring, perforation and panophthalmitis, others are conjunctivitis, episcleritis and scleritis which can cause staphyloma. Keratitis, loss of protective corneal reflex and damage to superficial nerves, chronic uveitis, loss of accommodation, low or elevated intraocular pressure, secondary glaucoma and phthisis bulbi are more of the ocular complications seen.