EYELID CHANGES IN LONG-STANDING LEPROSY

To describe eyelid changes in ocular leprosy, 74 patients (148 eyes or 296 eyelids) were examined, focusing on eyelid abnormalities. The adn exal examination included evaluation of the upper eyelid crease patter n, qualitative assessment of the orbicularis oculi muscle function, me asurement of the distance between the corneal reflex and the upper eye lid margin (margin reflex distance), and slit-lamp biomicroscopy of th e eyelashes and tarsal conjunctiva. Eyelash ptosis was a common findin g associated with a multiple upper eyelid crease pattern and trichiasi s. In the past, eyelash ptosis has probably been diagnosed as upper ey elid entropion or trichiasis, but in this series entropion was not obs erved. The distinction between eyelash ptosis, trichiasis, and upper e yelid entropion is important because the surgical management for each is different. Other true leprotic abnormalities of the eyelids are lag ophthalmos and lower lid ectropion.