Xerophthalmia: Vitamin-A-deficiency eye disorder

What is Xerophthalmia? 

 Xerophthalmia is a progressive eye condition that results from severe deficient levels of vitamin A in the blood and is characterised by dryness of the eye.  Vitamin A is an essential micronutrient that nourishes our eyes. Good eye has good tear duct functioning. When the tear glands work effectively, the eyes get lubricated enough and thus get the frontline defense system.  

When the tear glands are less active or inactive the eyes do not produce tears and this makes it dry. Cornea the first transparent layer becomes dry easily as it is in the contact with the outer air. This may cause corneal ulcer or erosion.  In Xerophthalmia the tear production decreases due to the less amount of Vitamin A.  Conjunctiva and cornea dry up easily and then start to form wrinkles. These changes in the cornea and conjunctiva start producing symptoms. 

If not treated promptly it can lead to night blindness, formation of spots on the eye and may damage the cornea and retina gradually leading to permanent blindness. Xerophthalmis is a rare eye disorder and it is most commonly seen in developing nations. People who have less or deficient levels of Vitamin A intake can develop this eye disorder with time. 

Treatment of xeropthalmia can be done early with the vitamin A supplements and eyesight can be preserved. 

What are the common signs and symptoms of Xerophthalmia? 

The sign and symptoms of Xerophthalmia are:

• dry eyes; dry cornea and conjunctiva
• wrinkles appear slowly and gradually over the conjunctiva of the eyes. 
• formation of spots, white spots on the scleral portion of eye, also called Bitot's spot
• less or diminished vision at night, also called night blindness
• tired or fatigued eye
• cornea becomes too soft, keratomalacia
• formation of corneal ulcers or scar

Such symptoms are enough to cause eye discomfort when closing and opening the eyelids, and a person may feel pricking sensation in the eyes.  People may experience headache issues due to the dryness of eyes. 

What are the causes of Xerophthalmia? 

The main cause of Xerophthalmia is severe form of Vitamin A deficiency and it results due to the diet intake that is deficient in Vitamin a rich sources. 

Vitamin A, also known as retinol is a major nutrient that is responsible for maintaining our eyes' health and this can be obtained by Vitamin A rich sources in our diet.  

To ensure our eyes' health we all need to understand the importance of vitamin A and have a knowlegde of sources that are rich in Vitamin A. 

From what food sources do we get Vitamin A?

Vitamin A rich sources are: 

• Gooseberries or amla are the topmost rich sources of Vitamin A.  If you have gooseberries easily available, add it to your diet. Your eye health and vision will always remain perfect. 
• carrots: Carrots are also one of the richest source of Vitamin A. 
• Yellow-colored fruits: Papaya,pineapple, mango, guava. Yellow vegetables such as sqaush and pumpkin, etc. all the orange colored fruits do contain a generous amount of Vitamin A to nourish your eyes. 
• Green leafy vegetables such as Spinach, coriander and kale
• Dairy products: Cheese, milk, paneer, butter etc. are also good sources of Vitamin A. 
• Meat , codliver oil and other fishes are also good source of Vitamin A
• Foods that are fortitfied with vitamin A 

Who can get Xeropthalmia? What are the risk factors for Xerophthalmia? 

Xerophthalmia occurs to the people who either have severe deficiency of vitamin A due to food intake or their food intake contains Vitamin A but their body cannot process or use Vitamin a effectively due to underlying health conditions. 

In both the above cases, the eyes are affected along with some other vital organs. 

Risk factors for Xeropthalmia are: 

Age: Children who do not get good amount of vitamin A through food are more at risk to develop xerophthalmia. Infants and children are more seen affected by Xerophthalmia due to Severe form of Vitamin A deficiency. children may also develop complications of diseases such as measles or respiratory infections that cause Xerophthalmia. 

Such children may become more susceptible and develop night blindness if not treated and may even get blindness. It is called childhood blindness. Vitamin A supplementation plays a major role in reverting the condition. 

Lesser or no doses of Vitamin A: Vitamin A is added as a supplementaary nutrition shots in the Immunisation schedule by WHO. Babies who do not receive the proper Vitamin A doses may have delayed growth and mental development. It may progress to Xerophthalmia if vitamin A is not given at its earliest. 

Malnutrition: Less or no intake of vitamin A rich food sources may put a person at risk of developing Xerophthalmia slowly and gradually.  Dietary intake with less than recommended vitamin A affects the general health of our eyes. 

Poor economical condition: Poverty may play a role in having Xerophthalmia. Many people in underdeveloped or developing nations cannot afford rich sources of Vitamin A and or may be ignorant of the importance of Vitamin A for eye health. 

Underlying medical conditions: People with chronic liver conditions such as hepatitis, cirrhosis of liver, pancreatitis, gall bladder infection or inflammatory bowel disease, diabetes, etc. may have reduced absorption of Vitamin A in the blood and this may put them at risk of Xerophthalmia.

How is Xerophthalmia or Dry eye diagnosed in the hospital? 

• An ocular examination done by the ophthalmologist may help reveal the symptoms such as corneal softness, wrinkles on the conjunctiva and specifically the Bitot's spot. 
• Your doctor may ask about your dietary pattern and what foods you generally consume.
• A blood test may be done to check out the levels of vitamin A in your blood. 
•  Your recent medical history and family history may be asked by your doctor.
• Your doctor may get your night vision and adaptation tests to rule out the night blindness. 
• Your retinal response to different light intensities may also be checked by doing electroretinogram. 

What is the treatment of Xerophthalmia? 

Xerophthalmia is a preventable as well as a treatable eye condition. 

Treatment with Vitamin A helps in Xerophthalmia. Early diagnosis and treatment proves to be crucial in restoring the normal eye acuity and health.

1. Vitamin  A supplementation  by oral or injections approach. 
2. Dietary advice for including vitamin rich sources
3. Antibiotics to prevent the risk of infection such as conjunctivitis, keratitis, dacrocystitis, etc. 
4. Eye care tips to promote the eye health as per doctor's consultation

Can we prevent Xerophthalmia? 

Xerophthalmia is a preventable eye condition and we must know what can we do to promote the health of our eye. 

Prevention of Xerophthalmia: 

• Consume vitamin A rich food sources to maintain the appropriate levels of Vitamin A in your body. Eat dark green leafy vegetables such as spinach and kale. Also eat yellow colored fruits and vegetables as they are rich sources of retinol. 
• Take the treatment of any underlying infections or medical conditions. 
• Control your sugar levels, if you have diabetes
• Take care of your eyes properly. 
• Do eye exercises and clean your eyes properly. 
• Get your infants every single dose of Vitamin A 

Xerophthalmia is a progressive eye condition characterised by severe dryness of eye caused due to a severe deficiency of Vitamin A. It is a preventable eye disorder and can be treated with Vitamin A supplementation to restore eye health.

Note: This blog post is for educational and informational purpose only . It is not a substitute for any medical advice and treatment. Seek the help of your doctor in any case.