hello steemians

today i am going to discuss about the xeropthalmia which covers the ocular menifestation of Vit. A deficiancy.

ETIOLOGY:

.Due to dietary deficiancy

.Due to defective absorption from the gut.

Vit A deficiancy is not a isolated problem but is almost associated with protein energy malnutrition[PEM].

WHO classsification

XN : Nightblindness

X1A : Conjuctival xerosis

X1B : Bitots spot

X2 : Corneal xerosis

X3A : Corneal ulceration/ Keretomalacia affecting less than one third cornral surface

XS : Corneal scar due to xeropthalmia

XF : Xeropthalmic fundus

CLINICAL FEATURES :

. NIGHT BLINDNESS : earliest symptom of xeropthalmia in children

. CONJUCTIVAL XEROSIS : one or more patches of dry , lusterless , nonwettable conuctiva in the form of emerging like sand banks in the receding tides . typical xerosis is associated with conjuctival thickening , wrinkling and pigmentation.

.BITOT'S SPOT : it is a raised silvery white, foamy, triangular patche of keratonised epithelium situated on the bulbar conjuctiva in the interpalpebral area . it is usually bilateral and temporal side.

. CORNEAL XEROSIS : earlist change in the cornea is punctate keratopathy , which begins in the nasal lower quadrant followed by haziness or pebbly drynes .

.CORNEAL ULCERATION/KERATOMALACIA : in this stage stromal defects due to colliquative necrosis occurs.

small ulcers occurs peripherally , these are circular in shape. larger ulcers are extend centrally , it may involve the whole cornea. longer stromal defect can cause blindness .

.CORNEAL SCAR : it occur due to healing defect . these are of different sizes , they may cover the pupillary area.

.XEROPTHALMIC FUNDUS : it is characterized by seed like, raised, whitish lesion scattered uniformly over the fundus at the level of optic disc.

TREATMENT:

LOCAL OCULAR THERAPY: artificial tears like cellulose methyl cellulose[CMC]

VITAMIN A therapy: oral administration is recommended method if vomiting is recureent then intramuscular route preffered

200000 IU unit above the age of 1 year orally

100000 IU IM

BELOW 1 year and 8kg weight of child

100000 IU oral

50000 IU IM

FOOD Fortication with vit A such as golden rice.

LONG term use of grean leafy vegetable, carrot, papaya and drum sticks etc.

IMAGE SOURCE :

https://encrypted-tbn0.gstatic.com
https://glutenfreeworks.com
https://dic.academic.ru

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