Assessment and treatment of the dry eye in leprosy.

During the period of existence of the Ophthalmologic Prevention Centre we have come across a large number of patients with corneal dehydration (dryness cornea, dry eye) due to various causes. We find that majority of the patients had a big improvement in their symptoms and the signs of the dry eye with just a simple prevention technique.

Lid surgery to reduce discomfort produces an unexpected improvement in visual acuity--a case presentation.

A significant cause of blindness in leprosy is corneal scarring secondary to corneal anaesthesia and lagophthalmos (Brand & ffytche 1985). Such patients may continue to experience considerable ocular discomfort, particularly when there is associated ectropion of the lower lid, with inflammation of the exposed tarsal conjunctiva (Courtright & Johnson 1991). Where visual outcome is no longer the primary consideration, one may hesitate to subject patients to surgery, particularly in relatively unsophisticated field conditions, attempting instead to relieve the patient's discomfort by conservative treatment such as frequent topical ocular lubricants, use of protective spectacles or eye shades etc. A case is presented here in which minor surgery aimed solely at relieving ocular discomfort resulted in an unexpected improvement in visual acuity. This suggests that there are instances where a more aggressive approach to treatment of even severely damaged eyes could prove more rewarding than anticipated.

Management of the eye in facial paralysis

Ocular complications in patients with facial paralysis may be minimal or they may be severe enough to seriously handicap a patient. This discussion is concerned primarily with solutions to eye problems resulting from facial paralysis.