Xerophthalmia: Causes, Symptoms, Prevention and Treatment

Xerophthalmia is an eye condition caused by a deficiency of vitamin A. When the body does not get enough vitamin A, the eyes and tear ducts can become dry. Over time, xerophthalmia can cause night blindness and even severe damage to the cornea, the outer layer of the eye. White patches and corneal ulcers may appear as the condition worsens. With timely vitamin A therapy, most cases of this can be reversed.

Causes of Xerophthalmia

The primary cause of this is a lack of vitamin A in the diet. Our body cannot produce vitamin A, so it must be obtained through food. Vitamin A plays a crucial role in vision as it helps in the formation of rhodopsin, a protein in the retina that absorbs light.

Apart from vision, vitamin A is essential for maintaining the health of the heart, lungs, kidneys, and other organs. This is rare in developed countries where people have better access to animal products, but it remains common in developing countries.

Symptoms Of Xeropthalmia

The symptoms of xerophthalmia can start mild and gradually become severe. The earliest sign is night blindness, which makes it difficult to see in low light. This is often the first indication of vitamin A deficiency in a population.

As the condition progresses, the conjunctiva, which is the thin covering of the eye, becomes dry, thick, and wrinkled. Other symptoms of this include the formation of Bitot's spots, which are white, foamy lesions on the eye, and corneal ulcers. In advanced cases, the cornea may liquefy, leading to permanent blindness if untreated.

WHO Grading of Xerophthalmia

The World Health Organization (WHO) has classified this to determine the severity of the condition. The WHO grading of xerophthalmia includes:

• XN: Night blindness, the earliest sign.

• X1A: Conjunctival xerosis, marked by dryness and rough texture of the conjunctiva.

• X1B: Bitot's spot, foamy white lesions on the eye surface.

• X2: Corneal xerosis, where the cornea becomes hazy and dull.

• X3A & X3B: Keratomalacia, liquefactive necrosis affecting part or most of the cornea.

• XS: Corneal scars, which may lead to thinning of the sclera and other complications.

• XF: Xerophthalmia fundus, changes in the retina, and reduced electroretinogram amplitude.

This grading helps doctors decide the treatment plan and understand the severity of this in patients. The WHO grading of xerophthalmia is also useful for public health programs to assess vitamin A deficiency in populations.

What Are the Sources of Vitamin A?

Vitamin A, also known as retinol, is a fat-soluble vitamin found in animal and plant foods. What are the sources of vitamin A? Animal sources include:

• Fish liver

• Poultry

• Meat

• Eggs

• Dairy products

Plant sources contain beta-carotene, which the body converts into vitamin A. What are the sources of vitamin A? Vegetables and fruits rich in beta-carotene include:

• Leafy green vegetables

• Carrots

• Mangoes

• Black palm oil

Including these foods in the diet can help prevent vitamin A deficiency and support overall health.

Risk Factors of Xerophthalmia

It is most common in children and infants due to poor nutrition. The main risk factors of xerophthalmia are poverty and inadequate intake of animal products. Young children are more affected because vitamin A is essential for growth and immunity against infections like diarrhea, measles, and respiratory illnesses.

Other risk factors of this include conditions that interfere with vitamin A absorption, such as alcoholism, cystic fibrosis, chronic diarrhea, liver disease, celiac disease, and radioiodine therapy for thyroid cancer.

Diagnosis of Xerophthalmia

Doctors diagnose this by checking the eyes for dryness, Bitot's spots, and corneal changes. A detailed medical history and diet assessment are also important. Blood tests can measure vitamin A levels to confirm deficiency. Early diagnosis is crucial because immediate treatment can prevent severe complications.

The diagnosis of xerophthalmia is straightforward if symptoms like night blindness or dry eyes are present. Eye examination and patient history help doctors provide timely treatment.

Treatment of Xerophthalmia

Treatment mainly involves vitamin A supplementation. In areas where it is common, preventive vitamin A capsules are given to reduce suffering and prevent fatalities. Educating people about nutrition and enriching foods with vitamin A also helps. Some fortified foods include oils, grains, milk, and sugar. Golden rice, genetically modified to contain beta-carotene, is another potential source of vitamin A.

The treatment of xerophthalmia is highly effective if started early. Night blindness often improves within 24–48 hours of vitamin A therapy. Severe corneal lesions may require more intensive treatment, but can still recover with timely intervention.

Prevention of Xerophthalmia

Prevention focuses on consuming enough vitamin A through diet or supplements. Foods like fish oil, liver, chicken, eggs, carrots, mangoes, milk, and leafy vegetables are good sources. Ensuring children and adults get sufficient vitamin A can prevent it and improve overall health.

Vitamin A therapy, along with a nutritious diet, can significantly reduce the risk of this and its complications.