Leprosy in a trachomatous population
I. R. Schwab, E. Nassar, R. Malaty, A. Zarifa, A. Korra and C. R. Dawson
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.
