Vitamin A Deficiency & Eye

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This presentation details about the relationship of Vitamin A deficiency and ocular manifestations and its treatment.

Published in: Health & Medicine

Vitamin A Deficiency & Eye

  1. 1. VITAMIN “A” DEFICIENCY AND EYE Dr. Ankit Punjabi P.G., Dept of Ophthalmology, K.I.M.S. Hospital, Bangalore Email; drankitalways@gmail.com
  2. 2. VITAMIN A <ul><li>FAT SOLUBLE </li></ul><ul><li>ESSENTIAL FOR </li></ul><ul><ul><li>IMMUNITY </li></ul></ul><ul><ul><li>GROWTH </li></ul></ul><ul><ul><li>MUCOSAL SURFACE MAINTENANCE </li></ul></ul><ul><ul><li>CELL DIFERENTIATION </li></ul></ul><ul><ul><li>REPRODUCTION </li></ul></ul><ul><ul><li>VISION </li></ul></ul>
  3. 3. SOURCES <ul><li>LIVER </li></ul><ul><li>COD LIVER OIL </li></ul><ul><li>BUTTER </li></ul><ul><li>EGGS </li></ul><ul><li>CHEESE </li></ul><ul><li>GREEN VEGITABLES, CARROTS, ORANGE, YELLOW FRUITS </li></ul>
  4. 4. METABOLISM <ul><li>LIVER STORES 90 % OF VIT. A </li></ul><ul><li>ACTIVE METABOLITES </li></ul><ul><ul><li>TRANS RETINOIC ACID </li></ul></ul><ul><ul><li>CIS RETINOIC ACID </li></ul></ul><ul><li>REGULATE EXPRESSION OF KERATINS AND MUCINS </li></ul><ul><li>RHODOPSIN IN VISUAL CYCLE </li></ul>
  5. 5. VIT. A DEFC. FACTORS <ul><li>ed INTAKE </li></ul><ul><li>IMPAIRED ABSORPTION </li></ul><ul><li>ALTERED STORAGE </li></ul><ul><li>INCREASED UTILIZATION </li></ul><ul><li>CHR. DIARRHOEA, MAL ABSORPTION </li></ul>
  6. 6. EPIDEMIOLOGY <ul><li>DEVELOPING COUNTRIES </li></ul><ul><li>125 MILLION PRESCHOOL CHILDREN </li></ul><ul><li>PEAK AGE 2-3 YEARS </li></ul><ul><li>BITOT’ S SPOTS PREVALENCE 0.5 % </li></ul>
  7. 7. CLINICAL FEATURES <ul><li>WHO CLASSIFICATION : </li></ul><ul><ul><li>XN NIGHT BLINDNESS </li></ul></ul><ul><ul><li>X1A CONJUCTIVAL XEROSIS </li></ul></ul><ul><ul><li>X1B BITOT’S SPOTS </li></ul></ul><ul><ul><li>X2 CORNEAL XEROSIS </li></ul></ul><ul><ul><li>X3A COR. ULCER <1/ 3 OF COR. SURFACE </li></ul></ul><ul><ul><li>X3B COR. ULCER >1/3 OF COR. SURFACE </li></ul></ul><ul><ul><li>XS COR. SCAR </li></ul></ul><ul><ul><li>XF XEROPHTHALMIC FUNDUS </li></ul></ul>
  8. 8. NIGHT BLINDNESS <ul><li>EARLIEST SYMPTOM </li></ul><ul><li>DIFFICULTY TO SEE IN DUSKY AND DARK ENVIRONMENT </li></ul><ul><li>VIT. A LEVEL < 0.70 MMOL / L </li></ul>
  9. 9. CONJUCTIVAL XEROSIS <ul><li>KERATINIZING METAPLASIA OF THE CONJ. </li></ul><ul><li>LOSS OF GOBLETS CELL AND MUCUS </li></ul><ul><li>LUSTERLESS, WRINKLED, RED AND OPAQUE APPEARANCE OF BULBAR CONJ. </li></ul>
  10. 10. BITOT’S SPOTS <ul><li>FOAMY, CHEESY, ELEVATED LESIONS </li></ul><ul><li>HP – DESQU. KERATIN, LOSS OF GOBLETS CELL, XEROSIS BACILLI </li></ul>
  11. 11. BITOT’S SPOT
  12. 12. CORNEAL XEROSIS <ul><li>SPK </li></ul><ul><li>SLIGHT HAZYNESS </li></ul><ul><li>LOSS OF LUSTER </li></ul><ul><li>INFERIOR LIMBUS </li></ul>
  13. 13. CORNEAL ULCER <ul><li>SMALL, ROUND, SHARPLY PUNCHED OUT LESIONS </li></ul><ul><li>START AT PERIPHERY </li></ul><ul><li>PROGRESS TO NECROTIZING KERATOMALACIA </li></ul>
  14. 14. KERATOMALACIA <ul><li>COMMAN IN MALUTRITAION, DIARRHOEA, MEASLES, PARASITIC INFECTIONS </li></ul><ul><li>GENERALIZED SOFTNING OF STROMA SLOUGHS DESCMETOCELE PERFORATION </li></ul>
  15. 15. KERATOMALACIA
  16. 16. CORNEAL SCARING
  17. 17. TREATMENT <ul><li>DIRECT </li></ul><ul><ul><li>SUPELIMENTATION </li></ul></ul><ul><ul><li>FORTIFICATION </li></ul></ul><ul><li>INDIRECT </li></ul><ul><ul><li>PUBLIC HEALTH MEASURES TO CONTROL DISEASES </li></ul></ul>
  18. 18. TT. OF DEFICIENCY <ul><li>3 DOSES OF 200,000 IU OF VIT. A ON DAYS 0,1 & 14 </li></ul>
  19. 19. PREVENTION <ul><li>VIT. A PROPHYLAXIS IN ENDEMIC AREAS </li></ul><ul><ul><li>INFANTS < 6 MONTHS – 50000 IU ( NOT BEING BREAST FED) </li></ul></ul><ul><ul><li>6-12 MONTHS 100,000 IU </li></ul></ul><ul><ul><li>CHILDREN > 12 MONTHS UPTO 6 YEAR 200,000 IU EVERY 6 MONTHS </li></ul></ul><ul><ul><li>LACTATING WOMEN 200,000 IU ONCE </li></ul></ul>
  20. 20. PREVENTION <ul><li>HEALH AND NUTRITIONAL EDUCATION FOR VIT. A RICH FOODS </li></ul><ul><li>FORTIFICATION OF FOODS WITH VIT. A </li></ul><ul><li>PUBLIC HEALTH MEASURES FOR PREVETION OF DIARRHOEA AND OTHER INFECTIVE DISEASES </li></ul><ul><li>IMMUNISATION </li></ul><ul><li>ENCOURANGEMENT OF BREAST FEEDING </li></ul>
  21. 21. <ul><li>Thank you </li></ul>

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