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[Evaluation of the conjunctiva of leprosy patients using impression cytology]
1Department of Ophthalmology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo 173-8606, Japan.
Objective:
To evaluate ocular surface disorders (OSD) similar to cicatricial pemphigoid in leprosy patients.
Subject And Method:
Sixteen leprosy patients were examined. They were under treatment as inpatients at the Tama Zenshoen National Sanatorium, an institution for the treatment of leprosy. In addition to routine ophthalmological examinations, the patients conjunctival goblet cells were examined using impression cytology. OSD similar to ocular cicatricial pemphigoid were defined as the presence of at least two items of the following: symblepharon, cicatricial contraction of the conjunctival sac, corneal neovascularization, and palpebral entropion.
Results:
OSD was present in 8 of the 16 patients (50%). Goblet cells were either decreased in number or absent in 7 cases(44%), and included 4 cases with OSD. Six of the 7 cases(86%) with reduced or absent goblet cells had been diagnosed as leprosy prior to 1944.
Conclusion:
Reduction or absence of goblet cells is a frequent feature in leprosy patients, particularly in longstanding ones of 56 years or more. Insufficient initial treatment appears to be a major cause of this finding.