Vitamin A Deficiency & Eye

VITAMIN “A” DEFICIENCY AND EYE Dr. Ankit Punjabi P.G., Dept of Ophthalmology, K.I.M.S. Hospital, Bangalore Email; drankitalways@gmail.com

VITAMIN A
FAT SOLUBLE
ESSENTIAL FOR
IMMUNITY
GROWTH
MUCOSAL SURFACE MAINTENANCE
CELL DIFERENTIATION
REPRODUCTION
VISION

SOURCES
LIVER
COD LIVER OIL
BUTTER
EGGS
CHEESE
GREEN VEGITABLES, CARROTS, ORANGE, YELLOW FRUITS

METABOLISM
LIVER STORES 90 % OF VIT. A
ACTIVE METABOLITES
TRANS RETINOIC ACID
CIS RETINOIC ACID
REGULATE EXPRESSION OF KERATINS AND MUCINS
RHODOPSIN IN VISUAL CYCLE

VIT. A DEFC. FACTORS
ed INTAKE
IMPAIRED ABSORPTION
ALTERED STORAGE
INCREASED UTILIZATION
CHR. DIARRHOEA, MAL ABSORPTION

EPIDEMIOLOGY
DEVELOPING COUNTRIES
125 MILLION PRESCHOOL CHILDREN
PEAK AGE 2-3 YEARS
BITOT’ S SPOTS PREVALENCE 0.5 %

CLINICAL FEATURES
WHO CLASSIFICATION :
XN NIGHT BLINDNESS
X1A CONJUCTIVAL XEROSIS
X1B BITOT’S SPOTS
X2 CORNEAL XEROSIS
X3A COR. ULCER <1/ 3 OF COR. SURFACE
X3B COR. ULCER >1/3 OF COR. SURFACE
XS COR. SCAR
XF XEROPHTHALMIC FUNDUS

NIGHT BLINDNESS
EARLIEST SYMPTOM
DIFFICULTY TO SEE IN DUSKY AND DARK ENVIRONMENT
VIT. A LEVEL < 0.70 MMOL / L

CONJUCTIVAL XEROSIS
KERATINIZING METAPLASIA OF THE CONJ.
LOSS OF GOBLETS CELL AND MUCUS
LUSTERLESS, WRINKLED, RED AND OPAQUE APPEARANCE OF BULBAR CONJ.

BITOT’S SPOTS
FOAMY, CHEESY, ELEVATED LESIONS
HP – DESQU. KERATIN, LOSS OF GOBLETS CELL, XEROSIS BACILLI

BITOT’S SPOT

CORNEAL XEROSIS
SPK
SLIGHT HAZYNESS
LOSS OF LUSTER
INFERIOR LIMBUS

CORNEAL ULCER
SMALL, ROUND, SHARPLY PUNCHED OUT LESIONS
START AT PERIPHERY
PROGRESS TO NECROTIZING KERATOMALACIA

KERATOMALACIA
COMMAN IN MALUTRITAION, DIARRHOEA, MEASLES, PARASITIC INFECTIONS
GENERALIZED SOFTNING OF STROMA SLOUGHS DESCMETOCELE PERFORATION

KERATOMALACIA

CORNEAL SCARING

TREATMENT
DIRECT
SUPELIMENTATION
FORTIFICATION
INDIRECT
PUBLIC HEALTH MEASURES TO CONTROL DISEASES

TT. OF DEFICIENCY
3 DOSES OF 200,000 IU OF VIT. A ON DAYS 0,1 & 14

PREVENTION
VIT. A PROPHYLAXIS IN ENDEMIC AREAS
INFANTS < 6 MONTHS – 50000 IU ( NOT BEING BREAST FED)
6-12 MONTHS 100,000 IU
CHILDREN > 12 MONTHS UPTO 6 YEAR 200,000 IU EVERY 6 MONTHS
LACTATING WOMEN 200,000 IU ONCE

PREVENTION
HEALH AND NUTRITIONAL EDUCATION FOR VIT. A RICH FOODS
FORTIFICATION OF FOODS WITH VIT. A
PUBLIC HEALTH MEASURES FOR PREVETION OF DIARRHOEA AND OTHER INFECTIVE DISEASES
IMMUNISATION
ENCOURANGEMENT OF BREAST FEEDING

Thank you

Vitamin A Deficiency & Eye

by Ankit Punjabi

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Vitamin A Deficiency & Eye Presentation Transcript