Introduction: There are various controversial reports on intraocular pressure (IOP) in patients with leprosy.Purpose: The current study was undertaken to study the level of intraocular pressure in leprosy patients and its association with the risk factors.

Materials and methods: This was a prospective cross sectional comparative study. An ophthalmologist and a dermatologist evaluated consecutive 93 patients with leprosy. The risk factors studied were age, gender, bacillary index, clinical diagnosis, duration of disease and treatment; and ocular complications. The IOP in these patients was compared with healthy age and sex matched controls. 

Results: A total of 186 leprosy patients (93) and healthy controls (93) were studied. The mean applanation IOP for the right and left eyes in leprosy patients was 12.87 ± 1.20 mm of Hg and 13.22±2.70 mm of Hg respectively. This was found to be significantly lesser (p<0.001) than in the controls (RE=15.14±2.58 and LE=15.41±2.36mmHg). The untreated leprosy patients had significantly lower IOP than those with treatment (p<0.001). None of the risk factors were found to be independently associated with the decrease in IOP. The duration of treatment, however, showed a trend towards having a significant association (p=0.057) with the lower level of IOP. 

Conclusion: The level of IOP is lower in leprosy patients than in the healthy controls. Age, gender, bacillary index and presence of ocular complications due to leprosy are not independently associated with the decrease in IOP. The untreated leprosy patient tends to have a lower IOP. This finding can be used to monitor effectiveness of treatment of leprosy.