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. 1981 Apr;65(4):231–239. doi: 10.1136/bjo.65.4.231

Role of iris changes as a cause of blindness in lepromatous leprosy.

T J Ffytche
PMCID: PMC1039489  PMID: 7236566

Abstract

Clinical and pathological investigations in a group of 113 patients with leprosy of long duration demonstrated the importance of iris changes as a cause of blindness. In lepromatous leprosy the so called "chronic iritis" produces iris atrophy with small nonreacting pupils which exaggerate the visual impairment created by developing lens changes and corneal opacities. The cause of this "chronic iritis" is believed to be neuroparalytic from early involvement of the small nerves of the iris, particularly the autonomic supply. Clinical and pharmacological evidence for this theory is supported by the histological changes observed in 18 specimens of iris removed during the course of cataract surgery, with progressive atrophy of the iris preferentially affecting the dilator muscle and leading to a nonreacting miosed pupil. Further pharmacological and histological studies are to be undertaken on lepromatous patients with iris involvement with a view to establishing possible methods of prevention.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ALLEN J. H., BYERS J. L. The pathology of ocular leprosy. I. Cornea. Arch Ophthalmol. 1960 Aug;64:216–220. doi: 10.1001/archopht.1960.01840010218007. [DOI] [PubMed] [Google Scholar]
  2. Allen J. H. The pathology of ocular leprosy. II. Miliary lepromas of the iris. Am J Ophthalmol. 1966 May;61(5 Pt 2):987–992. doi: 10.1016/0002-9394(66)90212-1. [DOI] [PubMed] [Google Scholar]
  3. Beretti J., Cahuzac G. Les lésions de la lèpre oculaire en Nouvelle-Calédonie. Arch Ophtalmol Rev Gen Ophtalmol. 1970 Apr;30(4):313–320. [PubMed] [Google Scholar]
  4. CAMERON A. N. Leprosy and its ocular manifestations. Trans Ophthalmol Soc U K. 1961;81:637–647. [PubMed] [Google Scholar]
  5. Choyce D. P. Diagnosis and management of ocular leprosy. Br J Ophthalmol. 1969 Apr;53(4):217–223. doi: 10.1136/bjo.53.4.217. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Choyce D. P. Kerato-uveal changes in leprosy and onchocerciasis: a question of immunity. Proc R Soc Med. 1972 Nov;65(11):955–960. [PMC free article] [PubMed] [Google Scholar]
  7. Drutz D. J., Chen T. S., Lu W. H. The continuous bacteremia of lepromatous leprosy. N Engl J Med. 1972 Jul 27;287(4):159–164. doi: 10.1056/NEJM197207272870402. [DOI] [PubMed] [Google Scholar]
  8. Emiru V. P. Ocular leprosy in Uganda. Br J Ophthalmol. 1970 Nov;54(11):740–743. doi: 10.1136/bjo.54.11.740. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Ffytche T. J. Cataract surgery in the management of the late complications of lepromatous leprosy in South Korea. Br J Ophthalmol. 1981 Apr;65(4):243–248. doi: 10.1136/bjo.65.4.243. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Grove D. I., Warren K. S., Mahmoud A. A. Algorithms in the diagnosis and management of exotic diseases. XV. Leprosy. J Infect Dis. 1976 Aug;134(2):205–210. doi: 10.1093/infdis/134.2.205. [DOI] [PubMed] [Google Scholar]
  11. HASHIZUME H., SHIONUMA E. ELECTRON MICROSCOPIC STUDY OF LEPROMATOUS CHANGES IN THE IRIS. Int J Lepr. 1965 Jan-Mar;33:61–82. [PubMed] [Google Scholar]
  12. HOBBS H. E. THE DIAGNOSIS OF UVEITIS IN LEPROSY. Lepr Rev. 1963 Oct;34:226–230. doi: 10.5935/0305-7518.19630034. [DOI] [PubMed] [Google Scholar]
  13. HOLMES W. J. Leprosy of the eye. Lepr Rev. 1957 Jul;28(3):108–123. [PubMed] [Google Scholar]
  14. HOLMES W. J. The eyes in leprosy. Trans Ophthalmol Soc U K. 1961;81:397–420. [PubMed] [Google Scholar]
  15. Harrell J. D. Ocular leprosy in the Canal Zone. Int J Lepr Other Mycobact Dis. 1977 Jan-Mar;45(1):56–60. [PubMed] [Google Scholar]
  16. Hobbs H. E., Choyce D. P. The binding lesions of leprosy. Lepr Rev. 1971 Jun;42(2):131–137. doi: 10.5935/0305-7518.19710017. [DOI] [PubMed] [Google Scholar]
  17. Hobbs H. E., Harman D. J., Rees J. W., McDougall A. C. Ocular histopathology in animals experimentally infected with Mycobacterium leprae and M. lepraemurium. 1. Mycobacterium leprae and M. lepraemurium infections in the mouse. 2. Mycobacterium leprae infections in the 9-banded armadillo (Dasypus novemcinctus L.). Br J Ophthalmol. 1978 Aug;62(8):516–524. doi: 10.1136/bjo.62.8.516. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. KENNEDY P. J. Ocular manifestations in leprosy. Am J Ophthalmol. 1952 Sep;35(9):1360–1364. [PubMed] [Google Scholar]
  19. KIRWAN E. W. Ocular leprosy. Proc R Soc Med. 1955 Feb;48(2):112–117. [PMC free article] [PubMed] [Google Scholar]
  20. King E. F. THE EYE IN LEPROSY. Br J Ophthalmol. 1936 Oct;20(10):561–569. doi: 10.1136/bjo.20.10.561. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Krassai A. Corneal sensitivity in lepromatous leprosy. Int J Lepr Other Mycobact Dis. 1970 Oct-Dec;38(4):422–427. [PubMed] [Google Scholar]
  22. Michelson J. B., Roth A. M., Waring G. O., 3rd Lepromatous iridocyclitis diagnosed by anterior chamber paracentesis. Am J Ophthalmol. 1979 Oct;88(4):674–679. doi: 10.1016/0002-9394(79)90663-9. [DOI] [PubMed] [Google Scholar]
  23. Prabhakaran K. Cataract in leprosy: a biochemical approach. Lepr Rev. 1971 Mar;42(1):11–13. doi: 10.5935/0305-7518.19710002. [DOI] [PubMed] [Google Scholar]
  24. Richards W. W., Arrington J. M. Unsuspected ocular leprosy. Am J Ophthalmol. 1969 Sep;68(3):492–499. doi: 10.1016/0002-9394(69)90721-1. [DOI] [PubMed] [Google Scholar]
  25. SCHWARTZ B., FELLER M. R. Temperature gradients in the rabbit eye. Invest Ophthalmol. 1962 Aug;1:513–521. [PubMed] [Google Scholar]
  26. SEARS M. L. Ocular leprosy. Am J Ophthalmol. 1958 Sep;46(3 Pt 1):359–361. doi: 10.1016/0002-9394(58)90263-0. [DOI] [PubMed] [Google Scholar]
  27. SPYRATOS S. Ponction de la chambre antérieure sur un cas d'iritis lépreuse; observations cliniques et cytologiques. Ann Ocul (Paris) 1954 Jun;187(6):538–545. [PubMed] [Google Scholar]
  28. Shields J. A., Waring G. O., 3rd, Monte L. G. Ocular findings in leprosy. Am J Ophthalmol. 1974 Jun;77(6):880–890. doi: 10.1016/0002-9394(74)90393-6. [DOI] [PubMed] [Google Scholar]
  29. Slem G. Clinical studies of ocular leprosy. Am J Ophthalmol. 1971 Jan;71(1 Pt 2):431–434. doi: 10.1016/0002-9394(71)90423-5. [DOI] [PubMed] [Google Scholar]
  30. Studdy P., Bird R., James D. G. Serum angiotensin-converting enzyme (SACE) in sarcoidosis and other granulomatous disorders. Lancet. 1978 Dec 23;2(8104-5):1331–1334. doi: 10.1016/s0140-6736(78)91972-4. [DOI] [PubMed] [Google Scholar]
  31. Swift T. R., Bauschard F. D. Pupillary reactions in lepromatous leprosy. Int J Lepr Other Mycobact Dis. 1972 Apr-Jun;40(2):142–148. [PubMed] [Google Scholar]
  32. Ticho U., Sira I. B. Ocular leprosy in Malawi. Clinical and therapeutic survey of 8,325 leprosy patients. Br J Ophthalmol. 1970 Feb;54(2):107–112. doi: 10.1136/bjo.54.2.107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. VOISIN J., LOMBARD G. Uvéite à hypopion chez un lépreux avec présence de bacilles de Hansen lors de l'examen de l'humeur aqueuse. Bull Soc Ophtalmol Fr. 1955 Feb;1-2:32–34. [PubMed] [Google Scholar]
  34. Weerekoon L. Ocular leprosy in Ceylon. Br J Ophthalmol. 1969 Jul;53(7):457–465. doi: 10.1136/bjo.53.7.457. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. Wood D. J. OCULAR LEPROSY. Br J Ophthalmol. 1925 Jan;9(1):1–4. doi: 10.1136/bjo.9.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]

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