Management is very important

1. Xerophthalmia
ZERA 1

2. ZERA 2

3.  Refers to all the ocular manifestations of
Vit A defiency
 Due to dietary deficiency or defective
absorption from the gut
 Ass with PEM & infections
ZERA 3

4. ZERA 4

5. Clinical features
 XN (night blindness) - It is the earliest symptom of
xerophthalmia in children
 X1A (conjunctival xerosis) - patches of dry, lustreless,
nonwettable conjunctiva
• Typical xerosis may be associated with conjunctival
thickening, wrinkling and pigmentation.
ZERA 5

6.  X1B (Bitot’s spots)
• It is an extension of the xerotic process seen in stage
X1A
• raised, silvery white, foamy, triangular patch of
keratinised epithelium, situated on the bulbar
conjunctiva in the inter-palpebral area
• usually bilateral and temporal
ZERA 6

7.  X2 (corneal xerosis)
 punctate keratopathy beginning in the
lower nasal quadrant
 haziness and/or granular pebbly dryness
 Lustreless
ZERA 7

8.  X3A and X3B (corneal
ulceration/keratomalacia)
• Stromal defects occur in the late stage due
to colliquative necrosis
• Small ulcers (1-3 mm) occur peripherally
• Large ulcers and areas of necrosis may
extend centrally or involve the entire
cornea
ZERA 8

9.  XS (corneal scars)
 Healing of stromal defects results in corneal
scars of different densities and sizes
 May cover the pupillary area
ZERA 9

10.  XFC (Xerophthalmic fundus)
 seed-like, raised, whitish lesions scattered
uniformly over the part of the fundus at the
level of the optic disc
ZERA 10

11. Treatment
 Local ocular therapy
• Artificial tears
• Full fledged BCU tx if keratomalacia occurs
 Vitamin A therapy
• Applies to all active stages of
xerophthalmia
• Oral administration is the recommended
method
ZERA 11

12. Treatment of underlying conditions
• PEM and other nutritional disorders
• Diarrhoea, dehydration and electrolyte
imbalance
• Infections and parasitic conditions
ZERA 12

13. Prophylaxis
 Short-term approach - comprises periodic
administration of vitamin A supplements
 Medium-term approach – food fortification
with vitamin A
 Long-term approach
• Ultimate aim.
• It implies promotion of adequate intake of
vitamin A rich foods such as green leafy
vegetables, papaya and drum- sticks
ZERA 13