Prevalence and etiologies of visual handicaps in leprosy patients in the south of Cameroon

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Abstract

We report on a prospective study undertaken in April 2008, in 11 leper villages of the Southern Cameroon. Our aim was to determine the prevalence and the causes of bilateral blindness, low vision and unilateral blindness in the population of leprosy patients, irrespective of the clinical aspects of the illness.

Results:

Two hundred thirty-five known and newly diagnosed leprosy patients were examined. These patients included 149 cases (63.4%) of multibacillary leprosy and 86 cases (36.6%) of paucibacillary leprosy. There were 111 case of visual handicap, representing 47.2% of the population. These visual handicap cases were subdivided into 45 cases (19%) of bilateral blindness, 35 cases (15%) of unilateral blindness and 31 cases (13.2%) of low vision.

Discussion:

The prevalence of visual handicap among leprosy patients in Cameroon is too high. Causes in the majority of cases are age-related degenerative pathologies, and one third of cases are linked to the leprosy mycobacterium.

Conclusion:

Discovering a cure for ophthalmic pathologies is important in order to provide a better quality of life for this particular population.

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Most cited references 9

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Ocular complications of leprosy in Cameroon.

P Nkeng, J Achu, A Ellong … (2001)

This study aimed to identify the main ocular complications of leprosy in Cameroon. It is a prospective cross-sectional study which took place from July 1998 to January 1999 in five leprosaria in Cameroon. The ophthalmological examination of all patients was performed by the same team. Of the 218 patients examined, 60.1% were males and 39.9% females. 72.5% had a paucibacillary leprosy and 27.5% a multibacillary form. 77.5% of patients had at least one ocular lesion and 38.3% of eyes had visual acuity < or = 1/10. Madarosis and anterior uveitis were more frequent in multibacillary forms while lagophthalmos and cataract were so in paucibacillary forms. Ocular complications are frequent in leprosy in Cameroonians. It is a true public health problem and it is important to prevent these lesions by early diagnosis and adequate treatment.

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Prevention of blindness in leprosy and the role of the Vision 2020 Programme.

M Hogeweg, J. Keunen (2005)

Leprosy control programmes are highly successful. As a result, leprosy control will be more and more integrated into the general health services. The existing vertical, specialized control programmes will be dismantled. Eye complications in leprosy have decreased. This is a result of earlier diagnosis and highly effective multidrug treatment (MDT) of leprosy, combined with timely treatment of secondary nerve damage by steroids. Most ocular morbidity is now found among elderly and disabled leprosy patients who were diagnosed before effective MDT treatment became available. Many of these patients live in leprosy settlements. Age-related cataract has become the leading cause of blindness in leprosy. The second cause of blindness is corneal opacification, mainly as a result of neglected exposure keratitis and corneal anaesthesia. The miotic pupils in late multibacillary leprosy, in combination with small central lens opacities, may also lead to blindness. The Vision 2020 Initiative prioritises cataract surgery. Leprosy patients should be actively included. Disabled leprosy patients can also benefit from screening programmes for refractive errors and the provision of spectacles and low vision aids. Determining the most feasible surgical methods for lagophthalmos surgery remains a challenge. For all health and eye care staff, training in leprosy and its eye complications is needed, as well as a change in attitude towards leprosy patients. Staff must be prepared to welcome them in the general health services.

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Ocular Findings in Leprosy in the United States

Richard Spaide, Richard Nattis, Andrew Lipka … (1985)

We examined 55 clinic patients with biopsy-proven Hansen's disease and catalogued the ocular findings. Forty patients had lepromatous disease and 15 had tuberculoid disease. Visual acuity was 20/40 or better in 52 patients. Examination of pupillary size in all cases and after dilation with cocaine and hydroxyamphetamine in 15 cases showed decreased sympathetic innervation to the iris dilator muscle in seven cases. Ocular inflammation was uncommon: there was one case of active interstitial keratitis, three of episcleritis, and four of iritis. Although 41 patients had ocular problems attributable to Hansen's disease, the severity of the ocular complications was much less than reported in similar studies from other countries. We believe that the differences were the result of effective antimicrobial and anti-inflammatory therapy.

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Author and article information

Journal

Journal ID (nlm-ta): Clin Ophthalmol

Journal ID (publisher-id): Clinical Ophthalmology

Title: Clinical ophthalmology (Auckland, N.Z.)

Publisher: Dove Medical Press

ISSN (Print): 1177-5467

ISSN (Electronic): 1177-5483

Publication date Collection: 2009

Publication date (Print): 2009

Publication date (Electronic): 2 June 2009

Volume: 3

Pages: 195-198

Affiliations

[1 ]Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Douala, Cameroon;

[2 ]Faculty of Medicine and Biomedical Sciences, University of Yaoundé I, Yaoundé, Cameroon;

[3 ]National Programme for Leprosy Control, Ministry of Public Health, Yaoundé, Cameroon

Author notes

Correspondence: André Omgbwa Eballé, Ophthalmology Unit, Gynaeco Obstetric and Paediatric Hospital of Yaoundé, PO BOX 4362, Yaoundé, Cameroon, Tel +237 99 65 44 68, Fax +237 22 21 24 30, Email andyeballe@ 123456yahoo.fr

Article

Publisher ID: opth-3-195

DOI: 10.2147/opth.s4495

PMC ID: 2709026

PubMed ID: 19668565

SO-VID: d58ab582-3641-4efc-8233-87a2c9a5534d

License:

This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

Prevalence and etiologies of visual handicaps in leprosy patients in the south of Cameroon

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Abstract

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Conclusion:

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Clinical Virtual Research Center Journal of Ophthalmology

Most cited references 9

Ocular complications of leprosy in Cameroon.

Prevention of blindness in leprosy and the role of the Vision 2020 Programme.

Ocular Findings in Leprosy in the United States

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