Xerophthalmia

Dr.Irma A. Pasaribu,Sp.Mata
Department of Ophthalmology

Definition
Semua manifestasi karena kekurangan
vit.A pada mata, termasuk:
Perubahan anatomi mata
Perubahan anatomi dan fungsi retina

Metabolism
Retinol (vit A)
Larut lemak, ditemukan dlm dagin,
ikan, fowl, diary products
Carotene (pro vitamin A)
Ditemukan pd daun hijau, sayuran
merah dan kuning, minyak2 dari
tanaman; hrs diubah mnjd vitamin A

Metabolism
50-90% retinol absorbed in intestines
Deposited in liver as retinol palmitate
Retinol palmitate enters bloodstream, combines
with retinol binding protein
Bound retinol palmitate leaves bloodstream and
enters epithelial tissues of whole body

Vitamin A Status & Clinical Condition

Vit.A stts: Sufficient
Input: Sufficient
Serum vit.A: Sufficient
Liver vit.A: Sufficient deposition

Normal demand: normal clinical condition

Increased demand (measles, fever, resp.
tract inf.): mild symptoms, supplements <

Vitamin A Status & Clinical Condition

Vit.A status: Poor
Input: diet poor in carotenes and vit.A
Serum vit.A: very low
Liver vit.A: very low or non-existant

Normal demand: very apparent symptoms

of VAD, night blindness, xerophthalmia
Increased demand (measles, fever, resp.
tract inf.): very high mortality

Early Detection of Xerophthalmia

Recognize the individual at risk
Recognize the community at risk
Know the sosio-ecologic indicators
associated with risk of vit.A deficiency

Clinical Features Deserving Special

Attention
History of poor vision in poor lighting or in
evening or in nighttime,
Other ocular symptoms
Frequent episodes of diarrhea, fever, or
respiratory tract infection
Helminthic infestation, or suspicion of
Measles or varicella infection

Clinical Features Deserving Special

Attention
Poor or no immunization history
Low birth weight
Indicator of Protein Energy Malnutrition (weight,
height, upper arm circumference, general
appearance)

Non Clinical Consideration in Early

Detection of Xerophthalmia
Breast feeding patterns: quantity and quality
Dietary patterns: frequency of feeding, type of
food, beliefs and attitudes concerning food
Employment and income

Therapy
Day one: vit.A 200.000 IU (100.000 IU for
<12 months of age)
Day two: same dose
After 1 week: same dose
2-4 weeks: same dose

Therapy
Improve nutritional status
Overcome accompanying diseases
Promotion of good nutrition, good health,
and good living conditions
Overcome poverty and ignorance

Prevention
Good nutritions, prevention of diseases,
good living conditions, attitudes and
behaviour supporting good health and
living
Vitamin A maintenance dose
Vitamin A distribution programs