Brandsma and Van Brakel proposed operational criteria for impairment in leprosy to improve application of the WHO grades. The authors are from the Green Pastures Hospital and Rehabilitation Centre in Nepal and the KIT Leprosy Unit in Amsterdam.
WHO impairments:
(1) for hands and feet
(2) for eyes
Parameters for eyes:
(1) visual impairment
(2) regular blink
(3) counting fingers at 6 meters
(4) lagophthalmos
(5) facial impairment from leprosy
(6) corneal opacities
(7) uveitis
Parameter |
Grade 0 |
Grade 1 |
Grade 2 |
visual impairment |
none |
mild to moderate |
severe |
regular blink |
normal |
absent |
absent |
counting fingers |
NA |
able at 6 m |
unable at 6 m |
lagophthalmos |
absent |
absent |
may be present |
facial impairment |
absent |
absent |
may be present |
corneal opacities |
absent |
absent |
may be present |
uveitis |
absent |
absent |
may be present |
where:
• Severe visual impairment is 6/60 or worse.
• Corneal sensation testing is no longer recommended but may be performed.
Purpose: To grade eye impairment using the operational definitions of Brandsma and Van Brakel.
Specialty: Sports Medicine & Rehabilitation, Infectious Diseases
Objective: severity, prognosis, stage, disability and performance
ICD-10: A30,