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Frequency of ocular complications of leprosy in institutionalized patients in NWFP-Pakistan

Abstract
Background: There is no systemic disease, which so frequently gives rise to disorders of the eye as leprosy does. The study was conducted to determine the prevalence and gravity of ocular complications in institutionalized leprosy patients in N.W.F.P. It is important to provide necessary information to leprosy healthworkers and general physicians in order to sensitize them to early detection and treatment or referral to appropriate centre. Methods: A prospective study of ocular complications of leprosy patients was conducted at the leprosy centre of Lady Reading Hospital Peshawar and the Leprosy Hospital Balakot, district Mansehra. The study included a record of the name, age, sex, type, duration of disease and completion of multidrug therapy(MDT). Classification of the patients was done according to Ridley and Jopling 5-group system. Visual acuity was tested by Snellen chart and those patients having a vision of less than 3/60 were labeled as blind. Ocular adnexa was examined by naked eye and lacrimal sac regurgitation test was done. Slitlamp biomicroscopy was done for anterior segment examination and direct ophthalmoscope was used for fundoscopy. Results: The authors studied 143 patients in the above mentioned leprosy centers. Out of these, 59 had lepromatous leprosy, 39-border line tuberculoid leprosy, nine tuberculoid leprosy, 33 borderline lepromatous leprosy, and three-border line leprosy. The male to female ratio was 4:1. The mean age was 53-year and mean duration of the disease was 19.0 years. The ocular complications were found in 73% of the patients. These complications included loss of eyebrows in 39 patients, loss of eyelashes in 23, corneal changes (including opacity, ulceration, and/or anesthesia) in 24, iridocyclitis in 20, lagophthalmos in 14, ectropion in 05, and chronic dacryocystitis in 3. Of the total of 15 (11%) patients, who went blind from ocular complications, 16 eyes did so due to corneal opacities, 06 eyes due to cataract, 05 eyes due to chronic anterior uveitis and one eye due to corneal ulcer, panophthalmitis and phthisis bulbi each. Geographical distribution; the majority of the patients came from the Northern districts of N.W.F.P, including Malakand division and district Mansehra. Conclusions: A significant number of leprosy patients (73%) have ocular complications. The frequency of ocular complications increases with the increasing age and duration of disease of the patients.

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Type
Journal Article
Author
Khan T
Awan A A
Kazmi A H

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