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Biomedical subjects

J Rohatgi

Publications and source records attributed to J Rohatgi.

10 recordsLinked to original sources
PubMed2004

Factors associated with sight threatening lesions of leprosy in patients on multidrug therapy.

One hundred and six consecutive patients (old and newly diagnosed) attending the leprosy clinic at Guru Teg Bahadur Hospital, Delhi, underwent a detailed ophthalmic examination to identify factors associated with the prevalence of sight threatening lesions of leprosy so as to delineate a sub-group of patients who should continue under active ophthalmic surveillance to prevent blindness. All of them were receiving multidrug therapy as recommended by WHO. Demographic data, systemic parameters and ophthalmic lesions attributable to the disease were endorsed on to a proforma. The data were analysed by chi-square test, discriminant analysis and multivariate regression analysis to isolate factors that could be associated with sight threatening lesions of leprosy. In 106 leprosy patients 212 eyes were examined; sight threatening lesions were found in 37 eyes (17.4%). The comea was involved most commonly (78.3%). The lesions were still present in 15.8% of patients who had completed multidrug therapy. Leprosy related visual impairment was seen in 2.3% eyes and blindness in 0.9% eyes. Factors significantly associated with sight threatening lesions included female gender, multibacillary leprosy, increasing duration of leprosy, thickened corneal nerves, subepithelial punctate corneal opacities and presence of any academic lesion of leprosy. On multivariate and discriminant analysis, female gender, thickened corneal nerves and duration of leprosy > 7 years were significantly associated with sight threatening lesions.

Adolescent↗
PubMed1987

Factors influencing corneal involvement in leprosy.

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.

Cornea↗
PubMed1987

Evaluation of precorneal tear film in leprosy.

The present study analyses the precorneal teat film using schirmer's test and tear film breakup time (BKUT) in 400 eyes of patients with various types of leprosy. An abnormal tear film BKUT (47.2%) was observed to be much more informative in the present series than the study of schirmer's test alone (25.4%). In patients with lagophthalmos an abnormal tear film BKUT (70%) was higher as compared to an abnormal schirmer's test (40%); while in cases of lagophthalmos with ectropion an abnormal schirmer's test was seen less frequently (26.8%) than in cases of lagophthalmos without ectropion (58.3%). This implied an increase in the aqueous content of the tear film in cases of lagophthalmos with ectropion on the basis of an associated chronic conjunctivitis. Lagophthalmos and ectropion have been identified as additional factors contributing to corneal morbidity. There was a statistically significant difference in the tear film abnormality in different types of leprosy, the maximal difference being in the lepromatous variety.

Humans↗
PubMed1987

Argon laser iridotomy in angle closure glaucoma.

Argon laser iridotomy was successfully performed in 30 eyes of glaucoma patients. A modified two stage procedure has been described to achieve a successful iridotomy in pigmented eyes. At the chosen site of laser iridotomy, partial thickness burns were applied in the first stage followed by a penetrating burns in the second stage. This minimised the complications associated with laser iridotomy and decreased the incidence of subsequent closure. At the end of 6 months follow up the success rate was 93.3 percent.

Adult↗
PubMedDate not supplied

Phlyctenular eye disease: a reappraisal.

PURPOSE: Phlyctenular keratoconjunctivitis is a nonspecific allergic response in the cornea and/or conjunctiva to a variety of distinct conditions. Tuberculosis as an etiological association is being supplanted by staphylococcal infection and worm infestation in developed countries. Our aim was to determine the relative frequency of the various known etiological factors of phlyctenular keratoconjunctivitis, and the clinical profile of the disease as it exists today in India, a country where tuberculosis is still highly prevalent. CASES: This is a prospective study of 112 consecutive patients with phlyctenular eye disease seen over a 2-year period. OBSERVATIONS: In 86 patients (76.7%), phlyctenular eye disease was associated with tuberculosis. Worm infestation was found in 14 patients (12.4%), whereas 7 (6.2%) had staphylococcal blepharitis. Thirteen patients had evidence of multiple etiology, of which one causative factor was always tuberculosis. When tuberculosis was the only association, 37% patients had severe lesions, whereas only 11. 5% patients without tuberculosis had such lesions. When tuberculosis along with another etiological factor was present, the incidence of severe lesions increased to 84.6%. Recurrence on follow-up was seen in three patients who were already on multidrug therapy for tuberculosis, and two who had tubercular allergy. CONCLUSIONS: Our study shows that tuberculosis is still a major cause of phlyctenular eye disease in India. Severe lesions are more common in patients with tuberculosis, especially when another etiological factor is associated. Recurrences are more common in patients with tuberculosis. Corneal lesions are less extensive than described in the literature and are no longer a significant cause of blindness.

Adolescent↗
PubMedDate not supplied

Leprotic keratopathy in India.

Corneal affections cause severe ocular morbidity in leprosy. Poor nutrition and low socio-economic status make the eyes prone to repeated secondary infections which makes the pattern of corneal disease in this country different from that reported in western literature. A study of 250 patients shows that leprotic keratopathy has 4 different patterns. Primary leprous keratitis was seen in 56.5% of cases, while secondary leprous keratitis (groups B, C & D) constituted 57.7%. In the latter group the ocular morbidity could be prevented by controlling infection and prevention of concomitant diseases. Cases of lepromatous leprosy showed a consistently higher incidence of different types of corneal involvement than tuberculoid cases.

Humans↗
PubMedDate not supplied

Uveal changes in leprosy.

A total of 424 leprosy patients were screened for uveal involvement. Uveal changes were found in 11.2% of these patients. Uveal involvement was more common in patients with greater duration of the disease and in patients on irregular Dapsone therapy. Of the patients with uveal involvement 82% were lepromatous, 16% were borderline and 2% were of tuberculoid leprosy. Uveal changes in form of active iridocyclitis (21.3%), healed iridocyclitis (58.5%), iris atrophy (10.6%), iris pearls (7.4%), small irregular pupil (46.7%), pupil refractory to dilatation (56.3%) were seen. Posterior segment involvement was rare. Lepromatous and borderline leprosy patients with no clinical evidence of uveal involvement had decreased power of accommodation as compared to normal subjects.

Adolescent↗