A deficiency of vitamin A can cause a clinical condition called Xerophthalmia. It is derived from the Greek words “xeros” which means dry and “ophthalmos” which means eye. The condition is characterized by the abnormal dryness and thickening of the conjunctiva and cornea. In this medical condition, the eye fails to produce tears usually the result of vitamin A deficiency. The conjunctiva and cornea will lose its luster and will have a skin-like appearance. If the condition is left untreated it can lead to corneal ulceration and eventually to blindness due to corneal damage.
Xerophthalmia is the major cause of preventable blindness in children all over the world. It is still a problem in developing countries since it is also associated with faulty feeding habits, ignorance, and poverty. It is common in children between the ages of 3 to 6 years. It is usually seen in children who eat very less vegetables and in infants weaned off from substances that are rich in vitamin A. Senior individuals are commonly afflicted with Xerophthalmia since tear production decreases as a person grows older. Adults with severe malnutrition or those with other health problems in which vitamin A deficiency in their diet is a factor can be afflicted with Xerophthalmia. Thermal or chemical burns due to an accident may also cause the condition.
Xerophthalmia can occur as a primary condition or as a secondary condition to another disease. Primary Xerophthalmia occurs when physical trauma such as being hit in the eye happens to a person. After the tear glands and/or tear ducts are damaged due to the physical trauma, dryness of the eyes occurs. If the eye is infected, dryness happens since the infection can cause damage to the glands that produce tears and moistens the eye. In secondary Xerophthalmia, the dryness of the eyes is a sign or symptom to another medical condition of an individual. Vitamin A deficiency is a common secondary cause of Xerophthalmia. Sjogren’s syndrome is another cause for secondary Xerophthalmia. In this medical condition, the tear glands are infiltrated by the T cell lymphocytes which destroy the normal gland and duct cells.
The symptoms for Xerophthalmia will vary slightly and will depend if the condition is primary or secondary. Early manifestation and symptom of Xerophthalmia is night blindness. The conjunctiva and cornea become dry (Xerosis) and lusterless. The development of Bitot’s spots or small plaques which are grey in color will occur. In severe cases, conjunctival ulcers leading to erosion will occur. The treatment of Xerophthalmia will depend on its cause. It can occur in two ways: treating the deficiency and treating the symptoms. Eating foods rich in Vitamin A and Vitamin A or multivitamin supplement are used to treat the deficiency. Artificial tears to lubricate the eyes are the principal symptomatic treatment used. Topical antibiotics are prescribed to prevent secondary bacterial infection. For patients with severe cases of Xerophthalmia, temporary or permanent closure of the tear drain is beneficial. Wearing of wrap-around glasses when outside, avoiding wind, heat, and strong light are also helpful. It is important that patients eat a lot of green leafy vegetables and drink lots of milk.
