Leprosy Mailing List – May 2nd, 2007
Ref.:
How to treat early lagophtalmus?
From: Saunderson P.,
Greenville, SC, USA
Dear
Salvatore,
Thank you for presenting such an interesting
case. It is a reminder that severe and complicated new cases of
leprosy can still turn up in a non-endemic area.
I would like to suggest that clear guidelines
for dealing with a case like this, in which complications are
developing, can be found in the ILEP Learning Guides, which are freely
available online at: http://www.ilep.org.uk/?id=63
You have already followed the advice on
treatment of reactions with steroids, as suggested in Learning Guide 2
and this is the most important aspect of treating early lagophthalmos.
It is to be hoped that your patient will fully recover from his
lagophthalmos over the coming weeks, with the steroid treatment, which
should follow a gradually reducing dose over six-months.
Learning Guide 4, on the Prevention of
Disability, gives exercises for lagophthalmos. While your
patient may recover without these, the exercises may help him to
recover strength in the eyelids more quickly and could prevent any
residual gap. The following is copied from the Learning Guide 4:
Mild Lagophthalmos:
1 When asked to close eyes lightly the person
has a slight gap between the eye lids.
2 Ask the person to try and close their eyes
with force. If the face muscles are still strong enough, the person
will be able to close the gap. They should keep the eye forced closed
while counting to ten. They should do this exercise as often as
possible every day.
With kind regards,
Paul
Dr Paul Saunderson MD, MRCP(UK)
Medical Director, American Leprosy Missions,
Head office: 1 ALM Way, Greenville, SC 29601,
USA
Personal address:
Østrem, 6013 Ålesund, Norway
Email: psaunderson@leprosy.org
