02939nas a2200337   4500000000100000008004100001260001300042653001500055653001000070653000900080653001000089653003000099653001100129653001100140653001200151653000900163653001600172653003000188653001800218653002100236100001300257700001400270700001400284700001300298700001200311245009500323300001000418490000800428520215100436022001402587       1994                            d  c1994 May10aAdolescent10aAdult10aAged10aChild10aEye Infections, Bacterial10aFemale10aHumans10aleprosy10aMale10aMiddle Aged10aResidence Characteristics10aUnited States10aVision Disorders1 aDana M R1 aHochman B1 aViana M A1 aHill C H1 aSugar J00aOcular manifestations of leprosy in a noninstitutionalized community in the United States.  a626-90 v1123 a<p><b>OBJECTIVE: </b>Our goal was to delineate the epidemiologic and clinical patterns of ocular leprosy in an outpatient setting in the United States.</p><p><b>DESIGN: </b>Examinations were performed in 61 consecutive outpatients seen in a Midwestern leprosy clinic.</p><p><b>PATIENTS: </b>Forty-three male and 18 female patients were examined. The patients' origins included Southeast Asia (24 patients [39%]), Latin America (23 patients [38%]), India (nine patients [15%]), Europe or North America (two patients [3%]), Africa (two patients [3%]), and the Middle East (one patient [2%]).</p><p><b>RESULTS: </b>Thirty-nine percent of patients were classified as having polar lepromatous leprosy; 18%, borderline lepromatous leprosy; 3%, borderline borderline leprosy; 36%, borderline tuberculoid leprosy; 2%, polar tuberculoid leprosy; and 2%, indeterminate leprosy. Ninety-six percent of patients had a best-corrected visual acuity of 20/40 or better. Ocular findings included madarosis (28 patients [46%]), subconjunctival fibrosis (18 patients [30%]), punctate epithelial keratopathy (17 patients [28%]), posterior subcapsular cataract (10 patients [16%]), corneal hypesthesia (10 patients [16%]), lagophthalmos (seven patients [11%]), corneal pannus (six patients [10%]), entropion (five patients [8%]), prominent or beaded corneal nerves (four patients [7%]), iridocyclitis (four patients [7%]), focal avascular keratitis (three patients [5%]), scleritis (three patients [5%]), interstitial keratitis (two patients [3%]), iris pearls (two patients [3%]), and ocular clofazimine crystals (two patients [3%]). Madarosis, corneal hypesthesia, and posterior subcapsular cataracts were significantly associated with disease duration (P < .05).</p><p><b>CONCLUSION: </b>We report herein a relatively low frequency of visual impairment attributable to leprosy in our series compared with that seen among institutionalized leprous patients. However, since 48% of subjects had one or more sight-threatening complications as a result of their disease, a program of regular ophthalmic follow-up is strongly advocated for all patients with leprosy.</p>  a0003-9950