Pattern and determinants of ocular complications in leprosy patients in eastern Nepal.

BACKGROUND

odular complications of leprosy can lead to blindness.

OBJECTIVE

to report the pattern and determinants of ocular complications in patients with leprosy from eastern Nepal.

METHODS

a cross-sectional study was carried out analyzing one hundred and eighty six patients of leprosy presenting between Jan 2002-Nov 2004. All the patients were categorized using WHO and Ridley and Jopling classification. After determining bacillary indices in all of them, a detailed ocular examination was carried out. Independent risk factors were determined for ocular involvement.

RESULTS

ocular complications were found in 30.65% of the leprosy patients; lagophthalmos (17.74%) was the most frequent followed by uveitis (8.60%). Most of the patients having visual loss had it due to corneal complications and none of the patients with uveitis had vision <6/18. The patients released from treatment (83.33%) and those currently on treatment (31.63%) had higher occurrence of complications. Risk factors for ocular involvement were higher bacillary index, longer disease duration (p-=0.031, RR=1.109, 95% CI=1.009-01.218) and decreased corneal sensation(p=0.001, RR=3.564; 95 % C I=2.014-6.306). Higher Schirmer values (p=0.012, RR=0.935, 95% CI=0.888-0.985) were found to be protective for ocular complications. STASTICS: SPSS ver 10.0 was used for data analysis. The P value of <0.05 was considered as significant.

CONCLUSIONS

the prevalence of complications is high in patients released from treatment for leprosy. Cornea-related complications are the most important cause of visual disability and blindness. Risk factors for ocular complications are higher bacillary index, longer disease duration and decreased corneal sensation.