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All ocular manifestations of vitamin-A deficiency including not only the structural changes affecting the conjunctiva, cornea and retina but also biophysical disorders of retinal rods and cone function.

  1. Etiology - Dietary deficiency of vitamin A or its defective absorption.
  2. New WHO Classification of Xerophthalmia*
XN Night blindness.
XIA Conjunctival xerosis
XlB Bitot’s spots.
X2 Corneal xerosis.
X3A Keratomalacia affecting less than one-third of corneal surface.
X3B Keratomalacia affecting more than one-third of corneal surface
XS Corneal scar due to xerophthalmia.
XF Xerophthalmic fundus.
  1. Treatment :
    1. Local ocular therapy
      1. Topical artificial tears
      2. If keratomalacia present, full-fledged treatment on the lines of bacterial corneal ulcer.
    2. Vitamin A Therapy
      > 1 year age
      1. 1 lakh IU of Vitamin A I/M injection given on 0, 1, 14th day
      2. 2 lakhs IU given orally on same schedule.
        < 1 year age Half the dose
    3. Treatment of underline: conditions
      1. Treatment of PEM-Protein Energy Malnutrition
      2. Other nutritional disorders like diarrhoea, dehydration and electrolyte imbalance.
  2. Prophylaxis of Xerophthalmia
    1. 6-12 months-l lakh IU orally every 3-6 months
    2. 1-6 years-2 lakhs IU orally every 6 months
    3. < 6 months-50,000 IU orally.
    4. Lactating mothers-20,000 IU orally once at delivery or during next 2 months.

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