Lack of vitamin A which is required for proper functioning of the retina & of epithelial cells. More common in children

Causes

• Malnutrition
• Severe childhood illness, eg. measles, whooping cough
Clinical features
• Night blindness
• Conjunctival dryness - see Xerophthalmia, p219
• Corneal ulceration (keratomalacia)
• Dry, rough and thickened skin (‘toad skin’)

Differential diagnosis

• Other causes of blindness, eg. glaucoma, trachoma, onchocerciasis, gonococcal ophthalmia, accidents, cataract

Investigations

Diagnosis is based on clinical presentation
Serum vitamin A

Management HC2

vitamin A: give 3 doses (days 1, 2 and 14)

< 6 months: 50,000 IU
6-12 months: 100,000 IU
over 12 months: 200,000 IU

Note

♦ Give prophylactic vitamin A to children with measles, malnutrition, chronic respiratory infections, persistent diarrhoea and to lactating mothers