Summary about Disease
Xerophthalmia is a progressive eye disease caused by severe vitamin A deficiency. It's characterized by dryness of the conjunctiva and cornea, leading to corneal ulceration, scarring, and potentially blindness if left untreated. It primarily affects children in developing countries.
Symptoms
Night blindness (Nyctalopia)
Conjunctival xerosis (dryness of the conjunctiva)
Bitot's spots (foamy, triangular patches on the conjunctiva)
Corneal xerosis (dryness of the cornea)
Corneal ulceration and keratomalacia (softening of the cornea)
Increased susceptibility to eye infections
Causes
Severe vitamin A deficiency
Malnutrition or inadequate dietary intake of vitamin A
Fat malabsorption syndromes (e.g., cystic fibrosis, celiac disease)
Liver diseases that impair vitamin A storage
Poverty and food insecurity in developing countries
Infections like measles that deplete vitamin A stores
Medicine Used
Vitamin A supplementation: Oral vitamin A is the primary treatment. Dosage varies based on age and severity of the deficiency.
Vitamin A Palmitate Injection: In severe cases, or when oral administration is not possible, vitamin A palmitate injection may be used.
Topical lubricants: Artificial tears can help alleviate dryness.
Antibiotics: Used to treat secondary bacterial infections in cases of corneal ulceration.
Is Communicable
No, Xerophthalmia is not communicable. It is a nutritional deficiency disease and cannot be spread from person to person.
Precautions
Consume a diet rich in vitamin A: Include foods like liver, dairy products, eggs, dark green leafy vegetables, and orange/yellow fruits and vegetables.
Vitamin A supplementation: High-risk populations, especially children in developing countries, should receive regular vitamin A supplementation.
Address underlying health conditions: Treat any underlying malabsorption syndromes or liver diseases.
Promote breastfeeding: Breast milk is a good source of vitamin A for infants.
Food Fortification: Use of Vitman A fortified foods.
How long does an outbreak last?
Xerophthalmia is not an infectious disease with outbreaks. However, in areas with widespread vitamin A deficiency, clusters of cases may appear, particularly during times of food scarcity. The presence of new cases would persist untill supplimentation and food fortification are done. The duration of new cases depends on how quickly and effectively vitamin A supplementation and dietary improvements are implemented.
How is it diagnosed?
Clinical Examination: Examination of the eye and looking for signs like conjunctival dryness, Bitot's spots, and corneal changes.
History: Taking a history of dietary intake, particularly regarding vitamin A-rich foods.
Serum Retinol Levels: Measuring serum retinol (vitamin A) levels can confirm vitamin A deficiency, though this test may not be readily available in all settings.
Impression Cytology: Collecting cells from the conjunctiva for microscopic examination.
Timeline of Symptoms
The progression of xerophthalmia symptoms is gradual:
Early Stage: Night blindness (Nyctalopia) is often the first symptom.
Later Stage: Conjunctival xerosis (dryness) develops, followed by Bitot's spots.
Advanced Stage: Corneal xerosis, ulceration, and keratomalacia occur, leading to scarring and potential blindness. The timeline can vary from weeks to months, depending on the severity of the vitamin A deficiency.
Important Considerations
Early diagnosis and treatment are crucial to prevent blindness.
Xerophthalmia is often a sign of broader malnutrition and food insecurity.
Public health interventions, including vitamin A supplementation programs and food fortification, are essential for prevention in high-risk populations.
Other eye conditions can mimic some symptoms of xerophthalmia; therefore, a thorough eye examination is necessary for accurate diagnosis.
Vitamin A supplementation should be administered under medical supervision, especially in children, to avoid the risk of hypervitaminosis A (vitamin A toxicity).