A satisfactory visual outcome following sequential oculoplastic procedures and small incision cataract surgery in an elderly patient with severe sequelae of ocular leprosy – A case report

The ocular manifestations of Hansen’s Disease (HD) are myriad and the sequelae of ocular leprosy often lead to severe visual compromise. Cataract surgery in such a patient is often not done immediately, as would normally be expected in the world today. The management of other sequelae have to be addressed before embarking on the management of cataract.

We report the successful management of an elderly patient, a treated case of HD who presented with bilateral lagophthalmos, paralytic ectropion, punctal obliteration, diminished corneal sensation, exposure keratitis and bilateral cataract. He underwent bilateral sequential oculoplastic and lacrimal procedures followed by small incision cataract surgery (SICS) in the eye with lesser corneal scarring and had a very satisfactory visual outcome in that eye. Paralytic ectropion in HD when associated with diminished corneal sensation requires adequate and early tarsorraphy to prevent exposure keratitis and subsequent corneal scarring. This simple oculoplastic procedure would go a long way in preserving useful vision in a patient afflicted by HD.