Lamba P A, Rohatgi J, Bose S
Department of Ophthalmology, Lady Hardinge Medical College, New Delhi, India.
Int J Lepr Other Mycobact Dis. 1987 Dec;55(4):667-71.
Corneal involvement in leprosy is known to be influenced by factors such as lagophthalmos, ectropion, and corneal anesthesia. In the present study conducted on 400 eyes of leprosy patients, observations were made on tear film abnormalities, and their relation to the above-mentioned factors was analyzed. The abnormality of tear film breakup time (BKUT) was found to be clinically more significant (47.2%) than a Schirmer's test alone (24.5%), and this finding was of greater significance in the lepromatous form of leprosy. An abnormal BKUT reflects a decreased mucin secretion by the conjunctival goblet cells. Tear film abnormalities in association with lagophthalmos, corneal anesthesia, concomitant ocular diseases, and environmental factors such as high relative humidity have been identified as factors contributing to corneal involvement in leprosy in India. It is not surprising that with so many mechanisms of corneal involvement the clinical manifestations are diverse, and all forms of pathological changes may contribute to corneal morbidity.
已知麻风病的角膜受累受兔眼、睑外翻和角膜麻醉等因素影响。在本项针对400只麻风病患者眼睛开展的研究中，对泪膜异常情况进行了观察，并分析了其与上述因素的关系。发现泪膜破裂时间（BKUT）异常在临床上比单独的泪液分泌试验（24.5%）更显著（47.2%），且这一发现在瘤型麻风病中意义更大。异常的BKUT反映了结膜杯状细胞黏蛋白分泌减少。在印度，已确定与兔眼、角膜麻醉、伴发眼部疾病以及高相对湿度等环境因素相关的泪膜异常是导致麻风病角膜受累的因素。鉴于角膜受累的机制众多，临床表现多样，且所有形式的病理变化都可能导致角膜病变，这并不奇怪。
