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Query: UMLS:C0022568 (keratitis)
 5,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The patient was affected by a lepromatous leprosy and had a unilateral oedema of the posterior layers of the cornea with a conjonctival hyperhemia. The authors review the various aspects of corneal changes in leprosy: -- paralytic and non specific changes in trigeminal paralysis; -- direct and specific changes: opacification of corneal nerves, a vascular keratitis, corneal leproma, disorders of the vascularisation either by pannus or by interstitial vascularisation. The epidemiological problems are briefly considered.
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PMID:[Corneal changes in leprosy (report of an autochtonous case) (author's transl)]. 732 43

Eyes from autopsy cases of leprosy patients (29 eyes from 16 cases) were examined histologically. In some cases immunohistochemical methods were used. In the lepromatous type, ocular complications such as keratitis and iridocyclitis were often found. In the tuberculoid type, such complications were seldom encountered. In the active stage, lepra cells and "foamy cells" showed positive reaction to acid-fast staining and anti-BCG antibody but in the silent stage they did not react. All foamy cells in both the active and the silent stage showed positive reaction to KP1, but they did not react to lysozyme or alpha 1-antitrypsin. These results suggest that the foamy cells originated from macrophages, but that their biological activity was low.
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PMID:[Ocular histopathological studies in leprosy in the silent stage--I. Light microscopic feature]. 794 45

Nocardia asteroides is a rare cause of keratitis usually associated with trauma. We report a case of corneal ulceration caused by N. asteroides in a patient with leprosy. This is the first case report of nocardial keratitis from Southeast Asia. The diminished corneal sensation in a patient with leprosy could be a predisposing factor for development or exacerbation of corneal ulceration.
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PMID:Corneal ulcer caused by Nocardia asteroides in a patient with leprosy. 1040 61

Responsibility for eye care of leprosy-affected persons should be shared between leprosy and eye care staff. Leprosy and PHC staff should be responsible for: treatment of reversal reactions in the face, and of recent lagophthalmos, with prednisolone, conservative treatment of mild lagophthalmos, referral of patients with severe lagophthalmos and/or exposure keratitis, unless there is sufficient expertise within the programme, recognition of the acute red eye and treatment of acute conjunctivitis, referral of all other conditions of acute red eye, unless there is sufficient expertise within the programme, recognition of severe visual impairment and referral as needed, recognition of the need for reading glasses in patients aged over 40 years, in rehabilitation services, encouraging medical colleges, Control of Blindness Societies, and staff of general eye care facilities, to actively take part in the treatment of eye complications in patients affected by leprosy, and encouraging charitable organizations to provide special eye care programmes for patients affected by leprosy, in particular for those who are disabled and are living in leprosy settlements. Eye care services (a visiting ophthalmologist or paramedical ophthalmic assistant to the specialized leprosy centres for consultation is an appropriate alternative and may sometimes be even more feasible) should take the responsibility for: eyelid surgery in patients with large lid gaps (> 6 mm), or, signs of exposure keratitis, and treatment and follow-up of acute iritis, corneal ulcers, foreign bodies, and other causes of 'the acute red eye', in cooperation with the leprosy service or PHC staff. The eye care services should offer 'positive discrimination' in the treatment of cataract-blind leprosy patients, realizing the great difficulties that these patients have in avoiding injuries or taking care of injuries once they have occurred, especially in the case of limbs that have lost protective sensation.
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PMID:Strategies for improvement of management of ocular complications in leprosy. 959 6

Ocular leprosy is rarely seen in developed countries. We report the long-term follow-up of a patient with bilateral uveitis, glaucoma, and keratitis. Skin, iris and aqueous humor biopsies disclosed abundant Wade-Fite-positive organisms consistent with Mycobacterium leprae. Leprosy must be considered in the differential diagnosis of keratitis and uveitis.
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PMID:Lepromatous uveitis diagnosed by iris biopsy. 978 35

Corneal disease is the second most common cause of blindness in tropical countries after cataract. It mainly strikes children who are exposed to numerous infectious agents against which they are unprotected due to the absence of basic health care. In high risk groups, the incidence of childhood corneal-related blindness is more than 20 times higher than in developed countries. There are many causes of corneal-related blindness. Endemic trachoma persists in some areas and inflammatory forms can lead to blindness. Eradication requires instillation of antibiotics in the eye, improvement of sanitary conditions, and campaigns against promiscuity. Xerophthalmia can induce blindness by perforation of the cornea in children with vitamin A deficiency. Measles, herpes simplex keratitis, and corneal ulcer that progresses to bacterial or fungal infections, or to amebic keratitis are also major causes of corneal-related blindness. The incidence of onchocerciasis is decreasing thanks to treatment with ivermectin and programs to control simulium. Neonatal gonococcal ophthalmia and leprosy-associated ocular disease can also lead to blindness. This overview of the various causes illustrates the close correlation between the level of life and living conditions and the occurrence of corneal-related blindness in tropical areas.
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PMID:[Corneal blindness in tropical areas]. 1090 81

Eduard Boeckmann (1849-1927) left a lasting legacy in Norway and in America. His scientific career started when as a medical student he won the Skjelderup gold medal for a study of the tonsils. In Bergen he presented his thesis, an experimental study dealing with the cause of keratitis, which affected many patients with leprosy. Later he published vigorously from his medical practice. In St. Paul, Minnesota, he constructed a steam autoclave based on principles that became fundamental in later autoclave technique. His autoclave was put into industrial production. In his own laboratory he worked with improvement and safe sterilization of catgut, and catgut was produced in St. Paul for 59 years, till 1960. He donated income from the catgut production to a fund for a medical library, today the Boeckmann Library of the United Hospital in St. Paul. Boeckmann had a high reputation as a doctor. His American patients were first of all Norwegian settlers in the north-western states. Both in Bergen and in St. Paul he was highly active in the professional associations.
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PMID:[Eduard Boeckmann--scientist, inventor and benefactor]. 1141 9

This is a report of an unusual case of Bipolaris mycotic keratitis infecting the corneas of both eyes in a cured, immunocompetent patient with previous borderline lepromatous disease. Bipolaris keratomycosis is probably more common than is generally appreciated, and is probably often overlooked in patients with Hansen's Disease.
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PMID:Bilateral Bipolaris keratomycosis in a borderline lepromatous patient. 1291 29

Leprosy control programmes are highly successful. As a result, leprosy control will be more and more integrated into the general health services. The existing vertical, specialized control programmes will be dismantled. Eye complications in leprosy have decreased. This is a result of earlier diagnosis and highly effective multidrug treatment (MDT) of leprosy, combined with timely treatment of secondary nerve damage by steroids. Most ocular morbidity is now found among elderly and disabled leprosy patients who were diagnosed before effective MDT treatment became available. Many of these patients live in leprosy settlements. Age-related cataract has become the leading cause of blindness in leprosy. The second cause of blindness is corneal opacification, mainly as a result of neglected exposure keratitis and corneal anaesthesia. The miotic pupils in late multibacillary leprosy, in combination with small central lens opacities, may also lead to blindness. The Vision 2020 Initiative prioritises cataract surgery. Leprosy patients should be actively included. Disabled leprosy patients can also benefit from screening programmes for refractive errors and the provision of spectacles and low vision aids. Determining the most feasible surgical methods for lagophthalmos surgery remains a challenge. For all health and eye care staff, training in leprosy and its eye complications is needed, as well as a change in attitude towards leprosy patients. Staff must be prepared to welcome them in the general health services.
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PMID:Prevention of blindness in leprosy and the role of the Vision 2020 Programme. 1630 90

The prevalence and incidence of ocular hypotony (IOP < 7 mm Hg) and factors associated with them were determined in a Leprosy Referral Centre at Tamilnadu, India. Applanation intraocular pressures were measured every six months in a cohort of newly diagnosed multibacillary (MB) leprosy patients who were followed-up during the two year period of multidrug therapy (MDT) and for five years thereafter. Transient hypotony was present in two patients at the time of diagnosis, in 3 patients during MDT and in 9 patients after MDT with a cumulative prevalence of 4.65%. Transient ocular hypotension was present in 24 patients (8%) at disease diagnosis. 25 patients developed hypotension during MDT that was associated with trichiasis (HR 8.83 95% CI 2.06, 37.78 p = 0.003) and flare or/and cells (HR 4.60 95% CI 1.08, 19.64 p = 0.039). 29 patients developed ocular hypotension after MDT that was associated with punctate keratitis and uveal involvement. In general, MB leprosy patients with hypotension had a mean IOP of 12.60 mm Hg which differed significantly (p < 0.0001) from the mean IOP of 14.9 mm Hg in those who did not have hypotension. Transient hypotension and hypotony in MB leprosy patients are associated with signs of intraocular inflammation.
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PMID:Ocular hypotension and hypotony in multibacillary leprosy patients; at diagnosis, during and after completion of multidrug therapy. 2143 94


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