Prevalence of ocular Leishmaniasis in district Chakwal

ABSTRACT

Cutaneous Leishmaniasis is endemic in Pakistan. The current study was undertaken in District Chakwal to measure the prevalence of ocular lesions in cutaneous leishmaniasis. A 60 years male presented to the Oculoplastic Clinic at Al- Shifa Trust Eye Hospital Rawalpindi, Pakistan, with an isolated chronic non-healing ulcerative lesion of left upper eye lid. Clinically suspected to be squamous cell carcinoma, it underwent total excision followed by Cutler-Beard reconstruction. The histopathology was cutaneous leishmaniasis. A team was dispatched to the health center, Choa Saiden Shah of the area to which the patient belonged [120 km southeast of Islamabad]. The area was found to be endemic for leishmaniasis. A total of 925 patients with known cutaneous leishmaniasis were registered for treatment at the health center and examined for ocular involvement. The prevalence of ocular lesions was found to be about 1%. Most of the lesions involved the skin of the upper eyelid. All the non-ocular patients were undergoing treatment with intralesional injection of Glucantime, while patients with exclusive ocular involvement were treated with intramuscular injections. Ocular involvement in Leishmaniasis is relatively rare, but it should be kept in mind in the differential diagnosis of ulcerative lesions of the eyelid especially in an endemic area