Xerophthalmia

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Dryness of the part of the eye ball exposed to air and light

Cause

  • Vitamin A deficiency

Clinical features

  • Starts with night blindness
  • Followed by dryness of the conjunctiva and cornea
  • Eventually the cornea melts away, the eye perforates, and total blindness occurs

Differential diagnosis

  • Trachoma, corneal injury

ManagementTreatment

  • Give vitamin A on day 1, repeat on days 2 and 14
  • Adult and child >1 year: 200,000 IU
  • Child 6-12 months: 100,000 IU
  • Child <6 months: 50,000 IU

If eyes show corneal clouding or ulceration, give care below to prevent corneal rupture and lens extrusion

  • Instil chloramphenicol or tetracycline eye drops 4 times a day, for 3-5 days
  • Instil atropine eye drops, one drop 3 times a day for 3-5 days

Prevention

  • Good balanced diet especially for children, women, and institutionalized persons, e.g., prisoners, long-term hospital in-patients, boarding school students, etc.
  • Routine Vitamin A supplementation
    • Child <5 years with measles or malnutrition: 100,000 IU
    • All mothers after delivery: 200,000 IU
    • A child above one year: 200,000 IU every 6 months