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

Cataract is a blinding disease occurring all over the world. One of the causes of cataract is leprosy. Sixty leprosy and 100 nonleprosy patients were assessed and underwent intracapsular cataract extraction. Leprosy patients with cataract were much younger than nonleprosy patients. The leprosy group had a significantly higher rate of complications and this was seen more in paucibacillary cases. There was a higher rate of visual disability in the leprosy group than in the nonleprosy group. Cataract was seen in younger patients in the leprosy group. This raised the possibility of leprosy being the cause of the cataract. The leprosy group consisted mostly of multibacillary cases, however unlike in other studies the rate of complications tended to be higher in the paucibacillary group. There were no preoperative findings that correlated with a low postoperative intraocular pressure.
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PMID:The pattern of cataract and the postoperative outcome of cataract extraction in Ethiopian leprosy patients as compared to nonleprosy patients. 903 2

The author analyzed the results of cataract surgery performed in 25 eyes of 22 leprosy patients. All the eyes were treated by phacoemulsification-aspiration technique with intraocular lens implantation. The subjects consisted of 15 eyes of 14 leprosy patients with past history of uveitis and 10 eyes of 8 leprosy patients without uveitis. The mean follow-up time after surgery was 20 months and 23 months, respectively. In 93% of eyes with uveitis and 90% of eyes without uveitis, the postoperative vision improved by 2 lines or more. Postoperative complications were higher among patients with uveitis (93%) compared with patients without uveitis (40%). But no serious complications were encountered in patients with uveitis.
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PMID:[Phacoemulsification-aspiration technique with intraocular lens implantation in leprosy patients]. 905 Mar 56

Visual disability continues to be a significant problem in leprosy patients due to cataract, chronic iridocyclitis, and corneal disease. Clinical and epidemiological aspects of these problems are described and the current status of eye care in leprosy programmes is discussed.
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PMID:Prevention of blindness in leprosy: an overview of the relevant clinical and programme-planning issues. 929 Aug 40

The objective of this study was to detect ocular lesions of newly diagnosed leprosy cases admitted to Istanbul Leprosy Hospital. The patients were categorized according to sex, age, type of leprosy and duration of the disease. Their eyes were categorized as with or without ocular findings due to leprosy. The total number of patients was 21. The mean age was 22+/-4.6 years, the duration of the disease was 36.3+/-19.6 months. Madarosis was the most common finding in this group. It was found in 15 patients (71.4%, 95% confidence interval (CI) 47.8-88.7%). As a second common finding related to corneal alterations, 13 patients had nerve thickening (61.9%, 95% CI 38.4-81.8%). None of our patients had trichiasis, episcleritis, scleritis, cataract, iris atrophy, iris pearl, abnormal vitreous or retinal findings.
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PMID:Ophthalmic findings of newly diagnosed leprosy patients in Istanbul Leprosy Hospital, Turkey. 954 44

In Belo Horizonte, Brazil, 70 eyes of 53 leprosy patients had extracapsular cataract extraction and intraocular lens implantation done during a period of four years. The authors analyzed the outcome regarding restoration of vision and complications after this procedure. The visual acuity improved in 92.9% of the eyes and in 65.7% the acuity had improved by four lines or more on the Snellen chart. The post-operative complications could not be associated only to leprosy infiltration; in any case, they were not too serious and could be controlled.
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PMID:Extracapsular cataract extraction and intraocular lens implantation in leprosy patients: visual outcome and complications. 959

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

Research is one of the four main activities of AITO. It is vital for the determination of health care priorities, and for the design, implementation, and evaluation of programs and projects in OCCCMED countries. Most of the research is surgical and focused on the diseases which cause blindness. Cataracts are the principal cause of blindness and have been the focus of many studies aimed at making surgery more accessible in terms of both geographical availability and cost. Trachoma is a major public health priority in the countries of the Sahel and a survey of its prevalence is underway in several countries. This study should lead to the development of preventive and curative treatments aimed at controlling blindness caused by trachoma by the year, 2020. Vitamin A deficiency, the cause of xerophthalmia and high mortality rates in infants, has been surveyed in several countries. A survey of glaucoma, another major cause of blindness which is often not recognized or treated, will be carried out in Bamako. Other studies focus on leprosy, malaria and the effects of visual disability on the quality of everyday life. It will be a major challenge over the next five years to develop the capacity within local populations to identify, design and implement research programs in community health aspects of ophthalmology that will take into account the needs and constraints of sub-Saharan Africa.
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PMID:[Research at the African Institute of Tropical Ophthalmology]. 964 37

Multidrug treatment of leprosy is being dramatically successful in sterilising the infection. However complications are still occurring, spoiling the result in some patients by residual damage, including to the eye. Prevention of this damage is imperative. It is stressed that eye complications will only lead to loss of sight if they are neglected. The lesions caused by leprosy in the eye are briefly described. The dangerous lesions are lagophthalmos causing corneal exposure, and iritis causing pupil block glaucoma. Frequency of the lesions were very common in the past, but seem to be becoming much less so, though good epidemiological studies are sparse. Cataract, mostly not caused by leprosy, is the commonest cause of loss of vision. Prediction of complications would facilitate prompt treatment, but despite some clues, prediction is at present inadequate and all cases must be watched. The management of complications is discussed: studies of the indications and outcome of surgery for lagophthalmos, and of intraocular lens implantation for cataract are priorities. If knowledge is to be put into practice to prevent blindness, training of front line staff and organisation of the service is central. Experience of these practical aspects in Uganda in recent years is described.
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PMID:The 22nd Kellersberger Memorial Lecture, 1997. Preventing loss of sight from leprosy. 1021 41

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

This case report depicts a case of histopathologically confirmed polar lepromatous (LL) leprosy with a bacterial index of 4+. He experienced recurrent episodes of erythema nodosum leprosum (ENL) in the first 5 years after diagnosis. Skin smears became negative after 6 years of dapsone monotherapy and have remained negative since that time. At 23 years after diagnosis, the patient had developed cataracts and underwent intracapsular cataract extractions with broad-based iridectomies. In one of the iris specimens, histopathologic examination revealed a focal granuloma composed of epithelioid cells. Subsequently a lepromin skin test showed a positive Mitsuda reaction with a borderline tuberculoid histopathology. This clearly illustrates the immunological upgrading of a polar lepromatous patient, perceived first in the iris tissue.
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PMID:Epithelioid granuloma in the iris of a lepromatous leprosy patient; an unusual finding. 1103 95


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