RESUMO
Leprosy, also known as Hansen's disease, affects millions of people worldwide and is largely confined to the developing world. Although Hansen's disease is disfiguring, crippling, and even blinding in its later stages, it is not commonly lethal but gradually steals sensory input from the digits and the visual pathways. In this article, the epidemiology and pathogenesis of leprosy are reviewed, with an emphasis on ocular involvement, treatment, and prevention.
Assuntos
Infecções Oculares Bacterianas , Hanseníase , Antibacterianos/uso terapêutico , Cegueira/prevenção & controle , Dapsona/uso terapêutico , Infecções Oculares Bacterianas/tratamento farmacológico , Infecções Oculares Bacterianas/patologia , Humanos , Hanseníase/tratamento farmacológico , Hanseníase/patologiaRESUMO
In an Egyptian leprosy hospital, 17% of 133 patients had a visual acuity of less than 3/60. Corneal opacity, phthisis bulbi, and cataract accounted for 85% of blindness. Leprosy and trachoma together produce blinding corneal opacity by exposure, leprous keratitis, and trichiasis and entropion. Inturned lids, a late result of conjunctival scarring due to childhood trachoma, were less frequent in patients with lepromatous leprosy than in patients with tuberculoid leprosy; because conjunctival scarring from trachoma depends on cell-mediated immunity, patients with lepromatous leprosy may not have had severe trachomatous scarring develop due to their lifelong abnormality in cellular immunity. In patients with leprosy, even when complicated by trachoma, simple measures to prevent or restore vision include medical treatment of leprosy, surgical correction of lid deformities, sector iridectomy for constricted pupils or central corneal opacities, and cataract extraction.