title: Patterns of ocular morbidity and blindness in leprosy--a three centre study in Eastern India.
abstract: 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.
authors.affiliation: Purulia Leprosy Hospital, Purulia, 723101, West Bengal, India. kirsteenjt@doctors.org.uk
authors.forename: Kirsteen J
authors.initials: KJ
authors.lastname: Thompson
authors.forename: Gwen M
authors.initials: GM
authors.lastname: Allardice
authors.forename: G Rajan
authors.initials: GR
authors.lastname: Babu
authors.forename: Helen
authors.initials: H
authors.lastname: Roberts
authors.forename: Walter
authors.initials: W
authors.lastname: Kerketta
authors.forename: Aalo
authors.initials: A
authors.lastname: Kerketta
mesh_terms: 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
chemical_list: D007917:Leprostatic Agents