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 :
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