Conjunctival biopsy in patients with leprosy.

The authors examined the eyes of 120 leprosy patients comprising of 30 cases each of tuberculoid, indeterminate, borderline and lepromatous leprosy. The investigation included biopsy of the bulbar conjunctiva on the upper temporal quadrant of the right eye. The study patients included both who were untreated, those that were being treated and those who were in observation after the end of treatment. The aim of the study was to identify the presence of M. leprae in the conjunctiva. Four such cases were found: one borderline patient with no treatment and three lepromatous patients who were being treated with MDT.

Bilateral iridocyclitis caused by Mycobacterium leprae diagnosed through paracentesis.

The authors conducted an anterior chamber paracentesis in a patient with lepromatous leprosy showing bilateral iridocyclitis. The paracentesis was performed in the outpatients department. The aqueous humor was studied by Ziehl-Nielsen staining method and the result was the isolation of the M. leprae in the anterior chamber. This study shows that M. leprae can promote uveitis in leprosy patients. Therefore, it should be looked for in patients having this type of disease.

Identification of M.leprae in conjunctiva of leprosy patients using the superior tarsal conjunctiva scrape technique.

The technique of superior tarsal conjunctiva scrape was used for identifying M.leprae in the conjunctiva in 56 leprosy patients (all of them multibacillary, some untreated and others treated with multidrug therapy). The technique of tarsal conjunctiva scrape was shown to be more suitable than conjunctival biopsy for identifying lepra bacilli. This technique is also easier to perform and has shown a statistical relation between bacilloscopical index of skin (BIsk) and bacilloscopical index of tarsal conjunctiva (BIconj) values. Thus, if the bacilli can be identified at tarsal conjunctiva we can assume greater systemic bacillary load in the patients.