Recurrent scleritis in lepromatous leprosy.
BACKGROUND
Recurrent immune-mediated scleritis after adequate treatment of leprosy is not well documented in the literature. We describe an Australian resident with unilateral intra-ocular lepromatous leprosy who had persistent non-infectious scleritis.


METHODS
A man of Anglo-Indian ancestry initially presented with lepromatous leprosy and unilateral ocular involvement. The affected eye had an interstitial keratitis and a granulomatous anterior uveitis that responded to antileprotics and anti-inflammatory agents. Despite systemic cure with triple antileprotic therapy, he developed recurrent scleritis that required multiple scleral patch grafts for scleral thinning and, subsequently, an enucleation. Histology failed to demonstrate persistent infection, rather a chronic non-granulomatous scleritis, which was probably immune mediated.


CONCLUSIONS
This case demonstrates an ocular complication of leprosy that is infrequently reported. Patients with ocular involvement by leprosy are at risk of developing recurrent scleritis despite systemic cure with antileprotics.
Poon
A
A
Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia.
MacLean
H
H
McKelvie
P
P
D000867:Anterior Chamber / Q000382:microbiology; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D015353:Eye Enucleation; D015818:Eye Infections, Bacterial / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005500:Follow-Up Studies; D006801:Humans; D007917:Leprostatic Agents / Q000627:therapeutic use; D015440:Leprosy, Lepromatous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009166:Mycobacterium leprae / Q000302:isolation & purification; D012008:Recurrence; D012590:Sclera / Q000637:transplantation; D015423:Scleritis / Q000209:etiology* / Q000473:pathology / Q000601:surgery
D000900:Anti-Bacterial Agents; D007917:Leprostatic Agents