Ocular Findings among Filipino Patients with Leprosy in a Tertiary Hospital: A Cross-sectional Survey

Abstract

Background. Leprosy, a chronic granulomatous disease affecting mainly the skin and peripheral nerves, has widely recognized ocular complications. It is a significant cause of visual impairment in countries where it is still prevalent, including the Philippines.

Methods. This was a cross-sectional study that determined the clinical profile and distribution of ocular pathology among Filipino patients with leprosy seen at a tertiary institution in the Philippines.

Results. A total of 67 patients consented to be included in the study and were evaluated by an ophthalmologist. Thirty-seven out of the 67 patients diagnosed with leprosy had reported ocular findings. The average age was 41.2 ± 13.1 years and the majority of patients were men (78%). Thirty-six patients were multibacillary cases, 10 (27%) had a lepra reaction, and 24 (65%) were undergoing multi-drug therapy. Three patients had varying degrees of visual acuity impairment (one was visually impaired with visual acuity [VA] 6/24-6/60, one with VA 3/60-5/60, and one with VA <3/60). Steroid-induced cataracts occurred in four patients (6%) with concurrent or previous systemic corticosteroid treatment for lepra reactions. Univariate logistic regression and Fisher’s exact test of patient-, disease-, and treatment-related variables on ocular morbidity revealed non-significant values for all variables except for age with an odds ratio of 1.1 (95% CI, 1.04, 1.16) (p = 0.001).

Conclusions. No ocular morbidities directly caused by leprosy were seen, and treatment-related ocular findings (steroid-induced cataracts) were the only morbidities documented. There is an age-related risk for developing ocular morbidity in patients with leprosy.