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Query: UMLS:C0086543 (cataract)
 29,165 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From 43 Nepalese leprosy patients skin smear negative, and treated with dapsone (diamino diphenyl sulphone), and without any sign of active leprosy or iritis, specimens from iridectomy during cataract surgery were studied histopathologically. Of 49 iris specimens only six (12%) were found to be without any histopathological change. Atrophy of the iris stroma was seen in 63% and neovascularisation in 6% of all cases. In 16% in which the dilator muscle could be detected, it was atrophic, and in 11% the pigmented epithelium was thinned and atrophic. Cellular inflammatory infiltrations were seen in 88% of all specimens. They were mostly slight in eyes which before operation had been without posterior synechiae of the iris. In most of the eyes in which posterior synechiae had been present moderate or heavy inflammatory cell infiltrates composed of lymphocytes and plasma cells, often associated with macrophages, neutrophils, or eosinophils, were found. In five iris specimens acid fast bacilli were present. This raises the question whether these can survive systemically despite dapsone chemotherapy in the iris, thus leading to dapsone-resistant leprosy and to recurrent iritis.
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PMID:Histopathological findings in the iris of dapsone treated leprosy patients. 168 88

This article provides a survey of the problems of prevention of blindness in developing countries. The World Health Organization estimates that 31 million people are blind and 15 million people partially-sighted. The main cause of blindness is cataract. Other causes are trachoma, glaucoma, xerophthalmia, river blindness, corneal scars and leprosy. Prevention or treatment of these causes is possible in more than 80% of cases. The number of blind persons, however, is still increasing due to the increase in population and the immense shortage of all kinds of ophthalmological equipment and personnel. An effective strategy for the prevention of blindness in developing countries should focus on: more cheap cataract operations, increasing teaching facilities for ophthalmic personnel, integration of ophthalmic care into the general health system and the promotion of blindness prevention in political organizations.
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PMID:Points of action in the campaign against blindness in developing countries. 179 Jul 53

Forty-eight leprosy patients in The Netherlands were re-examined 10 years after initial examination. Forty-six of these patients had received a course of multidrug therapy (MDT), according to the World Health Organization recommendation, at the time of their initial examination. Two patients had burned-out disease and had been merely under observation. Out of 40 patients, who initially did not show eye complications due to leprosy, 37 patients were essentially the same 10 years later. The eyes had changed in 3 multibacillary patients: 1 patient had developed a late type 1 reaction with facial nerve involvement and lagophthalmos; 2 patients had undergone intra-ocular surgery for cataract and acute glaucoma, respectively. Out of 8 patients with pre-existing eye involvement, 1 patient recovered and the lesions in 2 patients remained unaltered. One patient showed progression of pre-existing exposure keratitis. Four patients had undergone cataract extractions; all four patients were lepromatous, with a long history of disease and signs of iris involvement at the first examination. The main progressive lesions were cataracts in lepromatous patients.
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PMID:Progression of eye lesions in leprosy: ten-year follow-up study in The Netherlands. 189 Mar 62

An analysis of data derived from standardized surveys of the ocular findings in cross-sections of the leprosy population in 23 areas is presented. It shows that 24.3% of the patients completing multidrug therapy and 32.9% of those completing sulphone monotherapy have on-going eye problems which have the potential to lead to blindness or severe visual impairment. Most of the ocular complications involve the lids, cornea and anterior uveal tract, but a significant proportion of patients had cataract threatening vision. If left unsupervised, many of these patients will develop major visual problems which could have been avoided. It is important that completion of systemic leprosy therapy should not be regarded as a guarantee that the eyes are safe, and that regular ocular supervision should be continued long after the patient has been classified as 'cured'.
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PMID:Residual sight-threatening lesions in leprosy patients completing multidrug therapy and sulphone monotherapy. 203 23

Out of 742 out-patients screened for ocular disease, 177 (24%) had eye lesions due to leprosy. These were more in the lepromatous spectrum of the disease and showed increasing trend with age of patient and duration of the disease. Madarosis was the commonest lesion (76%). The serious and sight threatening lesions like lagophthalmos, corneal anaesthesia, corneal opacities and ulcers, iritis and complicated cataracts constituted 8.22% of the lesions. Blindness due to corneal opacity and complicated cataract developed in 6 patients, constituting 3.4% of eye lesions with a prevalence rate of 0.8% among all the leprosy patients. Although the blinding lesions occurred in a very small percentage of patients, most of these are preventable through early recognition and institution of appropriate treatment. The simple techniques of examination to detect potentially sight threatening lesions should be taught to all leprosy workers to prevent blindness among leprosy patients.
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PMID:Eye lesions in leprosy. 260 83

All patients who had cataract surgery at the Schieffelin Leprosy Research and Training Centre, Karigiri, India, between January 1979 and April 1985 were studied to find out the outcome of that surgery. These patients included 291 leprosy cases and 89 nonleprosy cases. Postoperative complications were slightly higher among leprosy patients compared to the nonleprosy cases. Visual recovery was marred by preoperative corneal opacities in some of the leprosy patients. Eyes with chronic insidious type of iridocyclitis did not produce any devastating results postoperatively. Patients whose skin smears were still positive for leprosy bacilli did not show any major complication. All leprosy patients should be offered the benefit of cataract surgery for restoring sight because blindness in leprosy would mean a double handicap if they are already suffering from insensitive, deformed hands and feet.
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PMID:Cataract surgery on leprosy patients. 341 Nov 66

In recent years, blindness in developing nations has been increasingly recognized as a public health problem requiring new approaches. To better prepare eye care professionals to assume their multidisciplinary responsibilities as epidemiologists, health planners, administrators, and educators, a new conceptual model is presented. This eye care plan and delivery scheme for developing nations attempts to integrate three essential disciplines of blindness prevention (epidemiology, administration, and education) with six major causes of blindness (cataract, trachoma, glaucoma, xerophthalmia, onchocerciasis, and leprosy) at three levels of intervention (community, primary, and secondary). The result can be conceptualized as a three-dimensional geometric model. This spatial construct has many practical applications and should serve as a useful frame of reference for eye care professionals and organizations active in international ophthalmology and blindness prevention in developing countries.
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PMID:Public health ophthalmology: a comprehensive model for the prevention of blindness in developing nations. 369 89

It is well known that ocular changes occur in leprosy, but data on their frequency differ very considerably (0.8-100%). Two groups of lepers in Togo were examined: first, 206 lepers who had had the disease for approximately 10 years and a second group (101) patients who had been suffering from it for approximately 24 years and had severe mutilations. It became apparent that sooner or later all lepers suffer from ocular complications. The following symptoms were found: loss of the eyebrows in 40.8% (42.6%), loss of the eyelashes in 29.6% (34.6%), lagophthalmos caused by involvement of the 7th cranial nerve in 21.4% (31.7%), corneal changes in 34.5% (49.5%), uveitis in 5.8% (19.8%), atrophy of the optic nerve in 12.6% (11.9%) and cataract in 21.8% (12.8%). The duration of the disease, the type of leprosy and the time when treatment was started are obviously the main factors associated with ocular changes in leprosy.
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PMID:[Eye involvement in leprosy. A study in Togo, West Africa]. 651 93

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.
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PMID:Leprosy in a trachomatous population. 669 69

Of 744 leprous patients, 61 (8.2%) had cataract-induced blindness; 46 patients (6.2%) were unilaterally blind and 15 (2.0%) were bilaterally blind. The mean age of patients with cataracts was 63.4 years in the tuberculoid-type leprosy and 56.4 years in the lepromatous type. The appearance of cataracts in lepromatous patients at an earlier age than in tuberculoid patients is significant (p less than 0.005). Of 41 cataractous eyes with posterior iris synechiae, 42.1% were observed in patients with tuberculoid-type leprosy and 59.1% in patients with the lepromatous type. Histopathological examination of 24 lenses showed that irregularities of the lens epithelium were present in 79.2%. Posterior iris synechiae were seen in 66.7% and fibrous pseudometaplasia in 41.7%. Posterior migration of the lens epithelium in the posterior subcapsular area was observed in 54.2%. In view of these clinical and histopathological findings, we discuss the probability that most cataracts in leprous patients are complicated in nature.
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PMID:Blindness from cataract formation in leprosy. 682 94


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