Dr.Meera Mohanakumar, M21293
A 38 year old male presented with sudden inability to close both eyes and epiphora of one month duration. Patient is a diagnosed case of borderline tuberculoid leprosy on MDT. On examination, he had bilateral lagophthalmos and the left cornea showed trophic ulcer secondary to exposure. Corneal sensations were absent in both eyes with reduced blink rate. There was a trophic ulcer measuring 5X5 cm over the right heel. To rule out other causes such as Diabetes, Sarcoidosis and HIV, blood investigations such as FBS/PPBS, serum ACE and Serology for HIV/HbsAg/HCV were done and found to be normal. Topical antibiotics and lubricants were ensued for exposure keratopathy, following which it resolved over a course of a month. Though reported rarely, in endemic countries, leprosy should be considered as an important cause of bilateral LMN facial paralysis. Screening of all such cases help in earlier identification of potentially sight threatening complications.
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