Xerophthalmia, keratomalacia and nutritional blindness

Abstract

Vitamin A deficiency remains a major cause of pediatric ocular morbidity. Over five million children develop xerophthalmia annually, a quarter million or more becoming blind. It is also a major pathway for measles-associated blindness, particularly in Africa. Treatment is practical and inexpensive, based upon the oral administration of 200,000 IU vitamin A on two successive days, at a cost of 10 cents U.S. Given the potential rapidity of corneal necrosis (keratomalacia) and the relative inaccessibility of health services to those at greatest risk, prevention is probably more important than treatment. Oral administration of high dose supplements (2000,000 IU every 3 to 6 months), vitamin A fortification of commonly consumed items, or best of all, increased dietary intake of natural sources of vitamin A will reduce the number of needlessly blind young children. Given recent evidence that vitamin A deficiency greatly increases overall mortality, even among children without evidence of xerophthalmia, the same prophylactic regimen may improve child survival by 35% or more.

Vitamin A deficiency in Nigerian children

“…Very surprising however, is that no single case of stage 3 (corneal ulceration) was found in this study. It may be that, since this represents a rather advanced stage (Sommer, 1982) of VAD, many of these children would most likely have developed other complications and succumbed because of the attendant high mortality. An interesting finding in this study, however was that many children with night blindness also had diarrhoea.…”

Vitamin A deficiency and xerophthalmia among school-aged children in Southeastern Asia

“…Thus, a xerophthalmia prevalence of 0.4% among preschoolers from a national survey in 1992 (Muhilal et al, 1994) was adopted for schoolers. This estimate is likely to be conservative, given a well-known trend for the prevalence of mild xerophthalmia to rise with age at least into the early school years (Sommer, 1982;Djunaedi et al, 1988;Muhilal et al, 1994), a lack of any VA supplementation program for this age group, and probably adverse nutritional effects from a national economic crises during the past decade.…”

“…An aggregate prevalence for all active stages of xerophthalmia was not reported; therefore, assuming that half of the children with XN also had XlB (Sommer, 1982), an aggregate prevalence of 2.6% was obtained by adding half of the prevalence rate of XN (0.5 Â 1.33%) to that of XlB (1.91%).…”

Serum levels of vitamin A, visual function and ocular surface after bariatric surgery

“…It is essential in the maintenance of the conjunctiva and corneal epithelium, phototransduction retinal and viability of the epithelial cells of the retinal pigment epithelium (24) . Night Blindness is a common complication of vitamin A deficiency (6) .…”