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KF Tabbara, HF El-Sheikh; Ocular Complications Associated with Cutaneous Leishmaniasis . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4288.
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Purpose: Cutaneous Leishmaniasis remains endemic in many regions of the world. The purpose of this study is to report the ocular complications of cutaneous Leishmaniasis. Methods: Seven patients from the southern region of Saudi Arabia presented to The Eye Center in Riyadh, Saudi Arabia. Five patients complained of decrease in vision in both eyes, two patients presented with lid deformity, and one patient complained of redness of the eye. History of cutaneous ulcers over the cheeks elicited in five patients, and two patients had cutaneous ulcers over the arms and cheek. Cutaneous ulcers appeared 6-12 months prior to the onset of ocular symptoms, and healed leaving scars. Laboratory work-up for uveitis, interstitial keratitis, and phlyctenulosis were negative. Results: There were five males and two female patients with an age range of 15-70 years and a mean age of 26 years. The clinical findings of cutaneous Leishmaniasis included ectropion of the lower eyelid with exposure keratopathy in two patients, interstitial keratitis in four patients, phlyctenulosis in two patients, and granulomatous uveitis in one patient. Visual acuity was less than 20/200 in four patients, and less than 20/50 in three patients. Conclusion: Cutaneous Leishamaniasis may be associated with serious vision threatening ocular lesions. Scarring of the lower eyelids following cutaneous ulceration resulted in exposure keratopathy and loss of vision in one patient. Interstitial keratitis, phlyctenulosis, and granulomatous uveitis may be associated with cutaneous Leishmaniasis. Loss of vision may result from exposure keratopathy or hypersensitivity to Leishmanial antigens. Early detection and prompt treatment of cutaneous Leishmaniasis may prevent the ocular complications.
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