Hanseníase ocular: uma abordagem histórica / Ocular leprosy: a historical approach

Houve uma acentuada queda na prevalência da hanseníase nas últimas três décadas. Contudo, a incidência não diminuiu na mesma proporção. Hoje, três anos após a última data estipulada pela Organização Mundial da Saúde para o controle da hanseníase, pacientes considerados curados ainda necessitam de cuidados especiais por causa de suas incapacidades e reações imunológicas. A literatura médica refere cegueira em 4 por cento a 11 por cento dos pacientes estudados e, mais de 20 por cento com graves problemas visuais devido a exposição da córnea, invasão bacilar e hipersensibilidade; estes mecanismos resultam em uma população de aproximadamente 1 milhão de pacientes cegos, embora a prevalência oficial não passe de 250.000 pacientes em todo o mundo. O autor destaca a necessidade de melhor tratamento e acompanhamento dos pacientes e, conclama os oftalmologistas a tornarem-se mais perceptivos e se interessarem mais pelo tratamento das complicações oculares da hanseníase.

A sharp drop in the prevalence of leprosy occurred in the last three decades. However, the incidence has not decreased at the same rate. Three years after the World Health Organization last deadline for leprosy control, patients considered healed still need special care for their incapacities and immunopathological reactions. Medical literature reffers blindness in 4 percent to 11 percent of studied patients and more than 20 percent with severe visual problems due to corneal exposure, bacillary invasion and hipersensibility. These mechanisms result in a population of nearly one million blind leprosy patients even though official prevalence accounts no more than 250,000 patients worldwide. The author calls for better patients management and follow-up and urges ophthalmologists to become more aware and interested in the treatment of the ocular complications of leprosy.

Spectrum of bacterial keratitis in a major eye hospital in Riyadh, Saudi Arabia

Bacterial keratitis is a major cause of ocular morbidity and an important cause of blindness from corneal scars in our region of the world. This review of the medical records of 100 consecutive patients with bacterial keratitis was carried out in order to determine the predisposing factors, and the causative organisms. All patients that had presented over the period of January 1986 to December 1987 to the emergency department of the King Khaled Eye Specialist Hospital in Riyadh, Saudi Arabia, were surveyed; 68 were male and 32 female. Among the cases where only a single organism was isolated, Staphylococcus epidermidis predominated [28 cases and%], Streptococcus pneumoniae was found in 18, and Pseudomonas aeruginosa in 18 patients [18% each]. Nineteen patients had mixed infections. The most common predisposing factor was antecedent ocular trauma, predominantly surgical: 56 patients had preceding surgery. In 38 of these, this had included corneal grafting. Fifteen% of the patients suffered from diabetes mellitus