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DESAFIOS PARA O DIAGNÓSTICO DA CATARATA E PREVENÇÃO DA CEGUEIRA NA HANSENÍASE

Abstract
Leprosy is a chronic infectious contagious disease caused by a bacillus, Mycobacterium leprae, which can cause ophthalmic lesions. The high frequency of ocular involvement in leprosy has been studied, in especially the cataract, despite disability prevention programs. This study aims to reflect about causes of cataract and blindness in leprosy considering the context of the prevention of the injuries. Articles published from 1998 to 2018 with descriptors [cataract] and [leprosy], associated with boolean connectors E/OR, were selected from survey of PubMed, MEDLINE, LILACS and SciELO databases. The way in which Brazilian Ministry of Health proposes the diagnosis of the disease during the treatment of leprosy patients is discussed, as well the differences from this to the specialized consultation with ophthalmologists. Seventeen studies present the incidence of cataract in leprosy patients in different countries. Evaluation of the cataract in public health service proposes the diagnosis by visual simple inspection associated with patient complaint or increased visual acuity. However, according to the guideline of the Brazilian Council of Ophthalmology, it is also necessary to evaluate the transparency of the lens in biomicroscopy mydriasis, an examination done with a slit lamp. Leprosy lesions can occurr during direct invasion of the eye by the bacillus, the involvement of the trigeminal and facial nerve, and hypersensitivity reactions. Leprosy may have no visual changes due to the size and location of the opacity area in the lens. These reasons justify an early assessment and the follow-up with ophthalmologists for the prevention of injuries, even after finished leprosy treatment. Lack of anticipated medical appointment with ophthalmologists could explain how ocular complications are related to loss of visual acuity, including blindness. It is important to provide medical appointment with ophthalmologists to all patients with leprosy, regardless of the symptomatology of visual acuity loss or change in opacity of the lens.

More information

Type
Book Chapter
Author
Herling JD
Miura H
Costa RM
Year of Publication
2020
Book Title
Medicina: Égide do Bem Estar Populacional
Chapter
6
Number of Pages
41-54
Publisher
Atena Editora
ISBN Number
9786557064559
DOI
10.22533/at.ed.5592005106