Keratoconjunctivitis sicca in leprosy

Our studies indicate that the patient with leprosy is at risk for developing keratoconjunctivitis sicca. The cause of keratoconjunctivitis sicca in our patients suggests that the aqueous layer of the tear film may be decreased as a result of a decrease in secretion of tears from the accessory lacrimal gland of the conjunctiva although it could also be decreased due to a diseased afferent arc to the lacrimal gland or to a diseased lacrimal gland both resulting in decreased aqueous production. In addition the stability of the precorneal tear film is probably affected due to a decrease in corneal sensation and to lagophthalmos both of which result in decreased blinking, as well as failure of the lid to resurface the tears because of irregularity of the conjunctiva or cornea. Our results suggest that patients with leprosy should be followed closely for keratoconjunctivitis sicca and that treatment directed towards this problem shoud be initiated early