ON LEPROUS CHANGE OF CORNEAL NERVES IN LEPROSY

Abstract

On this study, 11 eyes of seven cases of C, 2 eyes of one case of N and 2 eyes of one macular case were examined microscopically, which had been enucleated within two hours after death.
After formalin fixacion, Ishizu's modification of Cajal's silver impregnation method was used for staining nerves, which was combined with Ziehl-Neelsen's method, to examine both nerve and leprosy bacilli.
These 11 eyes of C are consist of 5 leprous pannus, 4 leprous pannus with keratitis punctata superficialis leprosa, and 2 keratrtis parenchymatosa.
In intact or slightly infiltrated part of the cornea a majority of nerves are normal, while in an intensive infiltrated part intact nerve fibres are seldom seen. In the letter part there is found a degeneration of axis-cylinder in various grades, such as spindle-shaped swelling, or splitting into granules or drop-shaph in hypopregnation.
Lepra bacilli are seen both in and among axis-cylinders. Sometimes round, spindle-shaped or cylindrical mass of bacilli are seen in nerve fibres. Bacilli are often seen in intact nerve fibres, without having leprous infiltration in its surroundings. These changes are not seen in neural and macular cases, except extinction of nerves in the opacity of keratitis a lagophthalmo with regeneration of nerves in its surroundings.
There is physiologically no blood vessels in the cornea, while usually lepra bacilli invade through the blood vessel in C type. This nerve seems to play greater part for an invasion of lepra bacilli in the conea as the corneal corpuscle does, t, i, lepra bacilli and infiltration invade into the cornea by means of nerve fibres, forming keratitis parenchymatosa. Specially it is remarkable that penetration of the Bowman's membrane by leprous infiltrations occurs along the penetrating nerve fibre.