Abstract
Purpose::
To describe the demographics, ophthalmic pathology and natural history of ocular lepromatous disease in patients cared for at the Lahey Clinic Hansen's Disease Center.
Methods::
The Lahey Clinic maintains one of only 11 National Public Health Service sponsored Hansen's Disease Centers. The Hansen's Disease Center at the Lahey Clinic is administered by the Departments of Infectious Diseases and Dermatology. Hansen's patients are referred to the Ophthalmology Department routinely for baseline evaluation and treatment of disease-related conditions. A review of patient charts and computer records for 61 individuals currently enrolled in the Hansen's Disease Center was performed. A database was then created to catalogue demographic information such as gender, country of origin and patient identification information. In addition, disease classification, ocular findings, treatments employed and outcomes of treatment were recorded. Where appropriate, photography was employed to record facial, anteior segment and posterior segment pathology.
Results::
There are 61 patients enrolled in the Hansen's Disease Center at the Lahey Clinic. Forty-eight of the 61 patients have been evaluated by the Lahey Clinic Department of Ophthalmology. Of the 61 patients, 21 are female versus 40 males (34.4% vs 65.6%). This patient population represents over 17 countries, but most patients are from Brazil (21 patients, 34.4%), Cape Verde (7 patients, 11.5%), and Vietnam (4 patients, 6.6%). Forty-nine of the 61 patients have been evaluated by the ophthalmology department for dry eye symptoms (11 patients, 18.0%), pterygium (11 patients, 18.0%), lid disorders (7 patients, 11.5%), exposure keratopathy or corneal scarring (6 patients, 9.8%), and chronic uveitis (5 patients, 8.2%).
Conclusions::
There are approximately 6,500 people living in the United States that are registered in the Hansen's Disease registry. It is estimated that 96 new cases were reported in the United States in 2002, and nearly 800,000 cases worldwide are reported. It is estimated that between 30 and 57% of people with Hansen's disease have some degree of ocular involvement. Hansen's disease has extensive effects on the eyes, and left untreated, can have devastating and permanent negative effects on vision and patient quality-of-life. It is our hope that this database will allow for earlier and more extensive screening in our Hansen's population, thus allowing earlier intervention and better visual and quality-of-life outcomes.
Keywords: clinical (human) or epidemiologic studies: prevalence/incidence • anterior segment • clinical (human) or epidemiologic studies: outcomes/complications