Xerophthalmia

Introduction

The term Xerophthalmia refers to the
spectrum of progressive eye diseases under Vitamin A deficiency. It ranges from night blindness to conjunctival xerosis, to Bitot’s spots, corneal xerosis and finally keratomalacial

Clinical features

  • Night blindness
  • Dryness of the conjunctiva and cornea (xerosis)
  • Tearing
  • Bitot’s spots
  • Corneal degeneration (keratomalacia)

Differential diagnosis

  • Measles keratoconjunctivitis

Complications

  • Corneal perforation
  • Corneal scarring
  • Blindness

Investigations

  • Conjunctival impression cytology (where available)
  • Serum Vitamin A levels

Management

Non-drug treatment

  • Nutrition education

Drug treatment

  • Vitamin A capsules 200,000 units orally daily for two days, then one capsule after one week
  • Topical antibiotics and antivirals where applicable
  • Padding the eye (for active corneal ulceration)

Caution

  • Avoid the use of harmful traditional eye
    medication

Prevention

  • Distribution of massive dose capsules of vitamin A to affected communities.
  • Nutrition and health education
  • Fortification of foods with vitamin A