Patterns of ocular morbidity and blindness in leprosy--a three centre study in Eastern India.
BACKGROUND
Eye disease and visual impairment due to leprosy are not uncommon, but their prevalence and the risk factors for such pathology have yet to be fully characterized.


METHODS
An observational study of leprosy-affected individuals in the community, in three districts in Eastern India was performed to determine the prevalence of ocular morbidity and blindness. The subjects were chosen by stratified random sampling, according to stage of treatment, or stage of post-treatment surveillance. Each subject underwent ophthalmic examination according to a standard pro-forma.


RESULTS
Thirty-three out of 1137 (2.9%) subjects were blind according to the WHO classification, and 232/1137 (20.7%) had moderate visual impairment. The prevalence of blindness and visual impairment was greatest in one centre, Jhalda. Multivariate Logistic Regression analysis showed that longer duration of disease, more advanced treatment stage and older age were independently associated with blindness. One hundred and forty-one cases (28%) in Muzaffarpur, 95 cases (63%) in Saldoha and 378 cases (78%) in Jhalda had active or treated multibacillary leprosy.


CONCLUSIONS
The prevalence of blindness in leprosy varies in different population groups, with differing patterns of leprosy-related ocular morbidity, blindness and disease type evident even in different areas of the same region. Leprosy screening and surveillance programmes should include ocular examination as part of routine screening, particularly in individuals with a history of multi-bacillary disease. Individuals with known sight- threatening pathology should undergo continued active follow up. Local epidemiological studies would enable appropriate programme planning and efficient allocation of resources.
Thompson
Kirsteen J
KJ
Purulia Leprosy Hospital, Purulia, 723101, West Bengal, India. kirsteenjt@doctors.org.uk
Allardice
Gwen M
GM
Babu
G Rajan
GR
Roberts
Helen
H
Kerketta
Walter
W
Kerketta
Aalo
A
D000328:Adult; D001766:Blindness / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D005128:Eye Diseases / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007917:Leprostatic Agents / Q000627:therapeutic use; D007918:Leprosy / Q000150:complications* / Q000188:drug therapy; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012720:Severity of Illness Index
D007917:Leprostatic Agents