Leprosy Mailing List – March 31st, 2007
Ref.: Corneal
ulcers related to cloth wraps touching the cornea during sleep
From:
Lehman L., Belo Horizonte, Minas Gerais, Brasil.
Dear Dr. Noto,
I have been following the messages and discussions on corneal
sensory loss. I have noticed that no Brazilians have commented
about this subject and feel they have a great experience to share with
readers. They do regular corneal sensory testing and
it is a part of Grade 1 impairment score. All other visible
signs are classified under Grade 2. Weakness with no lid gap
does not get recorded with a 1 but attention is given to this
weakness for appropriate treatment (corticosteroids, strengthening
exercises, ect)
I am currently travelling and am copying this message to Dr.
Wesley Campos and Dr. Norma Medina, Brazilian Ophthalmologists
and Hannelore Vieth, a nurse, who have a broad experience
with this area of testing corneal sensation. They have
specific work done in this area and perhaps they can share their
experiences with readers.
I must share that if there is corneal sensory
loss with the lagophthalmos, one must be very careful using cloth
wrapped around the eyes. In my field supervisions outside of
Brazil where this has been recommended, I have found several with
corneal ulcers related to the cloth wraps touching the cornea during
sleep. Care must be used to making sure the eye is covered where
the cloth cannot touch the eye.
Best wishes,
Linda Lehman
