Leprosy of the eye--a general outline.
Leprosy of the eye--a general outline.
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眼麻风病——概述。
DOI：
10.5935/0305-7518.19840013
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发表时间：
1984
期刊：
影响因子：
0.6
通讯作者：
M. Brand
中科院分区：
文献类型：
--
作者：
V. Joffrion;M. Brand
摘要麻风(汉森氏病)的眼部并发症严重威胁患者的生活质量。眼(眼前段结构)可能被分枝杆菌直接渗透和损害；可能受到炎症(II型反应)的损害，并由于眼外结构的变化而受损。这些都是本病的特征，处于或接近麻风病的末端。除了直接损害外，大约15%-20%的患者的眼睛，无论他们的疾病类型，都会由于神经损伤而受到异常暴露。这可能是运动引起的眼球迟钝，也可能是感觉神经(眼的末梢分支)引起的角膜感觉减退。其他病原体的继发感染使干燥和创伤引起的损害复杂化。风险最大的患者是患有活动的、长期存在的麻风病的患者。他/她的疼痛敏感度可能会降低。症状将是不可靠的。对这类患者进行常规客观检查成为强制性的。幸运的是，在相对简单的仪器的帮助下，大多数重要的病理学都是可见的。一旦建立了常规检查程序，可以在2到3分钟内完成有用的检查。本文对眼部麻风的病理生理、诊断和治疗的主要特点进行了概述。它的目的是帮助医生或其他卫生工作者承担起对麻风病患者的初级眼睛护理的责任，从而减少失明的可能性。四肢感觉丧失对任何人来说都是一个严重的障碍。失明加重了一种无法忍受的负担。
Summary Ocular complications from leprosy (Hansen's disease) seriously threaten a patient's quality of life. The eye (the anterior segment structures) may be infiltrated and damaged by the mycobacteria directly; may suffer damage from inflammation (Type II reaction), and be damaged as a result of changes in the extraocular structures. These are features of the disease at or near the lepromatous end of the spectrum. In addition to direct damage, the eye in about 15-20% of patients irrespective of their disease type, is subject to abnormal exposure due to nerve damage. This may be motor (c. 7) causing lagophthalmos, or sensory (terminal branches of ophthalmic division ofC.5) causing corneal hypaesthesia. Secondary infection by other pathogens complicates the damage initiated by dryness and trauma. The patient most at risk is the one with active, long-standing lepromatous disease. He/she will possibly have diminished pain sensitivity. Symptoms will be unreliable. Routine objective examination of such patients becomes mandatory. Fortunately, most of the significant pathology is visible with the help of relatively unsophisticated instruments. A useful examination may be done in 2 or 3 minutes once the routine has become established. An outline of pathophysiology, diagnosis and management of the main features of ocular leprosy have been presented in this article. Its aim has been to help the physician or other health worker to assume responsibility for the primary eye care of their leprosy patients and thus reduce the possibility of blindness. Loss of sensation of the extremities is a serious handicap to any individual. Blindness superimposes an intolerable burden.