Letter. Update on ocular leprosy
The report by Professor Gordon Johnson and the recommendations by Dr Paul Courtright summarise beautifully the Workshop on Practical Eye Care Guidelines for Leprosy Patients. (J Comm Eye Health 2001; 14: 25-26).
In addition, I would like to clarify one point on treatment of lagophthalmos: Recent lagophthalmos, independent of size of lid gap, should be treated first with a course of systemic steroids as per general guidelines for type 1 reaction and recent nerve damage in leprosy. Usually a duration of nerve damage of ≤6 months, is taken as indication for steroid treatment in leprosy.
Even recent lagophthalmos with a lid gap of 8-10 mm in mild closure may recover, provided steroid treatment is given in time. Meanwhile the cornea should be protected by conservative means in combination with blinking exercises. 1
1 Treatment of recent facial nerve damage with lagophthalmos, using a semi-standardized steroid regimen. Kiran KU, Hogeweg M, Suneetha S. Leprosy Review 1991; 62: 150-154.