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Recurrent scleritis in lepromatous leprosy

A Poon¹, H MacLean, P McKelvie

¹Royal Victorian Eye & Ear Hospital, Melbourne, Victoria, Australia.

Australian and New Zealand Journal of Ophthalmology

|April 2, 1998

Summary

Leprosy can cause recurrent immune-mediated scleritis in the eye, even after successful treatment. This rare ocular complication requires careful monitoring and management in affected patients.

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Area of Science:

Ophthalmology
Infectious Diseases
Immunology

Background:

Leprosy, a chronic infectious disease, can lead to various ocular complications.
Immune-mediated scleritis following leprosy treatment is infrequently documented.

Observation:

A case of unilateral intra-ocular lepromatous leprosy in an Australian resident.
Persistent non-infectious scleritis developed despite adequate antileprotic therapy and management of keratitis and uveitis.

Findings:

Recurrent scleritis occurred despite systemic cure of leprosy with triple antileprotic therapy.
Histopathology revealed chronic non-granulomatous scleritis, suggesting an immune-mediated process rather than active infection.
Surgical interventions including scleral patch grafts and enucleation were necessary due to scleral thinning.

Implications:

Patients with ocular leprosy are at risk for developing recurrent scleritis post-treatment.
This highlights the importance of long-term ophthalmic surveillance in leprosy patients with ocular involvement.
Understanding the immune-mediated nature of post-leprosy scleritis is crucial for appropriate patient management.

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