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Evaluation of ocular involvement in patients with Hansen's disease
Priscila Daiane Pavezzi1, Rodrigo Bueno do Prado2, Plinio Ângelo Boin Filho2
1Internal Medicine Department, Dermatology, Universidade Estadual de Londrina, Londrina, PR, Brazil.
Insights
Ophthalmologic changes are present in all Hansen's disease (HD) patients, with Meibomian gland dysfunction and dry eye being most common. Regular eye exams are crucial for managing HD-related ocular complications.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Public Health
Background:
- Hansen's disease (HD), a neglected tropical disease, causes significant physical and social burdens.
- Ocular complications affect a high percentage of HD patients globally, persisting even after cure.
- Understanding the spectrum of ocular involvement is vital for public health policy and patient management.
Purpose of the Study:
- To determine the prevalence and characteristics of ocular involvement in patients with Hansen's disease.
- To correlate ophthalmological findings with clinical and epidemiological variables in HD patients.
Main Methods:
- A cross-sectional study involving ophthalmological evaluations of 86 Hansen's disease patients.
- Data collected included diagnostic ocular findings, corrected visual acuity, and refractive errors.
- Statistical analysis correlated findings with patient demographics and disease characteristics.
Main Results:
- 100% of evaluated patients exhibited ophthalmological changes.
- Meibomian gland dysfunction (89.5%) and dry eye syndrome (81.4%) were the most prevalent conditions.
- Cataracts were found in 25.6% of patients; however, 97.7% had normal or near-normal visual acuity, with no bilateral blindness.
Conclusions:
- Ocular involvement is universal in Hansen's disease patients.
- Meibomian gland dysfunction and dry eye are highly prevalent, necessitating targeted management.
- Physical disability in HD patients is associated with increased ocular adnexa and globe alterations, underscoring the need for comprehensive ophthalmologic care.
Abstract:
Hansen's disease (HD) belongs to the group of neglected diseases and can cause physical deformities and disabilities, in addition to leading to social discrimination. Ocular involvement in HD is estimated at 70-75% worldwide. About 10-50% suffer from severe ocular symptoms and loss of vision occurs in approximately 5% of cases. Ocular changes may persist or worsen even after patients are considered cured and it is necessary to better understand these conditions in order to determine the need for additional public policies. The objective of this study was to identify the prevalence of ocular involvement in patients with HD at two specialist referral centers for treatment of the disease. A cross-sectional study was conducted with ophthalmological evaluations of patients with HD from June 2017 to June 2018. Diagnostic ocular findings, corrected visual acuity, and refractive error were described. Findings were correlated with patients' clinical and epidemiological variables. A total of 86 patients were evaluated, with a mean age of 50.1 years, predominantly males (59.3%), and with multibacillary HD (92%). The prevalence of ophthalmologic changes was 100% and the most common were dysfunction of the Meibomian glands (89.5%) and dry eye syndrome (81.4%). Cataracts were observed in 22 patients (25.6%), but best corrected visual acuity was normal or near normal in 84 patients (97.7%) and there were no cases of bilateral blindness. Patients with some degree of physical disability had more ophthalmological alterations, involving both the ocular adnexa (p = 0.03) and the ocular globe (p = 0.04). Ocular involvement is common in patients with Hansen's disease, reinforcing the importance of ophthalmologic examination in the evaluation and follow-up of these patients.
