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The changing face of leprosy
  1. K J Thompson
  1. Correspondence to: K J Thompson Tennent Institute of Ophthalmology, Gartnavel General Hospital, Great Western Road, Glasgow G12 0YN, UK; kirsteenjt{at}doctors.org.uk

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Still a cause of preventable blindness

The word “leprosy” tends to conjure up images from the past including the “lepers” described in New Testament times, perhaps as seen in the film Ben Hur, or those for whom “leper windows” were constructed in churches throughout Europe in medieval times. The fact that the term “leper” is now rendered obsolete in describing a person with the treatable mycobacterial disease known as leprosy, or Hansen’s disease, seems to have passed many people by. Speaking of leprosy in the current day context usually evokes a cautious curiosity in lay circles or, in Western medical circles, the admission of having no more than a line or two of textbook knowledge on the subject, and genuine interest in the fact that it can involve the eyes. Hansen’s statement that “there is no disease which so frequently gives rise to disorders of the eye as leprosy does,”1 may no longer hold true. However, despite the advent of multidrug therapy (MDT) in the early 1980s, leprosy remains a significant cause of visual impairment in countries where it is still prevalent.2

The prevalence of leprosy has been decreasing over the past 15 years, but as a sequel to the World Health Organization’s drive to encourage governments to aim for the elimination of leprosy by the year 2000, improved case finding in some countries, including India (which has approximately 70% of the world’s leprosy affected population), is thought to have contributed to an apparent increase in the observed incidence of new cases during the 1990s.3 This increasing incidence rate continues in some countries, and in the top 10 leprosy endemic countries, 65 000 children were diagnosed with leprosy in 2004. In India, however, over the past 2 …

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