Xerophthalmia treatment

The symptoms of vitamin D deficiency disease has been documented in 16th century literature. A clear picture of the basis for the disease and methods of treatment were unclear until the experiments by Sir Edward Mellanby (3,4). In the early 1920 s, cod liver oil was known to cure rickets and xerophthalmia. The name vitamin D was given to... 

Because of the potential teratogenic effects of high-dose vitamin A, caution must be taken in the treatment of severe vitamin A deficiency among pregnant women as well as women of reproductive age. Women of reproductive age should be treated with 200,000 IU only when they display active corneal xerophthalmia. For... 

WHO, UNICEF, IVACG Task Force Vitamin A Supplements. A Guide to Their Use In the Treatment and Prevention of Vitamin A Deficiency and Xerophthalmia. 2nd ed. World Health Organization, Geneva, 1997. 

Although rarely encountered in developed countries, vitamin A deficiency remains a global public health problem. The current World Health Organization recommendation for vitamin A treatment in children 1 year of age and older who are at risk (see Table 17-3) is one 200,000 lU oral dose every 3 to 6 months for prophylaxis, and three such doses for treatment and prevention of xerophthalmia. Animal studies (rat model) have shown some improvement in corneal epithelial fimction with topical vitamin A supplementation. In human trials, evidence is contradictory regarding the beneficial role of topical vitamin A application. The apparent mechanism is reduction of inflammatory components. 

Ng EW, Congdon NG, Sommer A. Acute sixth nerve palsy in vitamin A treatment of xerophthalmia. Br J Ophthalmol 2000 84(8) 931-2. 

Therapeutic uses—Retinol is valuable in the treatment of night blindness and xerophthalmia, malabsorption syndrome or obstructive jaundice, and malnourished people who show Bitot s spots or follicular keratosis. 

Sommer A, Tarwotjo I (1982) Protein deficiency and treatment of xerophthalmia. Arch Ophthalmol 100 785-787... 

Children with xerophthalmia and measles should be treated immediately with oral, high-potency vitamin A (200,000 lU) according to WHO and IVACG guidelines (Table 5) and provided other supportive nutritional and medical therapy as indicated. Corneal lesions should be topically treated with a suitable antibiotic (e.g., tetracycline or chloramphenicol) to prevent bacterial infection. Corneal xerophthalmia typically improves with VA treatment within 1 week, with complete resolution within 4 weeks. 

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