How Xerophthalmia Affects Children Tips for Parents to Protect Vision

Growing up a child involves multitasking parents along with multifaceted health. A crucial factor involved in a child’s development is vision. Eyesight is an important part of the overall health and well-being of the child. Xerophthalmia is a severe eye condition that can lead to irreversible blindness in children, which eventually hampers the overall standard of living. There are certain early signs and symptoms that one should notice in children so that this condition can be addressed as soon as possible.  

What is xerophthalmia?

Xerophthalmia is a gradually progressive eye condition typically caused by vitamin A deficiency in the body. It can lead to multiple pathogeneses, such as impairment of tear production and eye dryness, which cause irritation and inflammation, eventually damaging the conjunctiva and cornea of the eye. This results in ulcers inside the eyes, and if left untreated, it can be scarred and finally cause irreversible blindness. India is a developing country, and malnutrition is one of the country’s issues where xenophthalmia is more prevalent. However, there are government bodies prioritising preventable blindness strategies in children.  

Causes of xerophthalmia

The primary aetiology is vitamin A deficiency, and this deficiency occurs in many ways. They include:  

• Insufficient intake of vitamin A: Vitamin A-rich foods include carrots, sweet potatoes and green leafy vegetables, and not consuming these can lead to vitamin A deficiency.  
• Malabsorptive disorders: There are many malabsorptive disorders. However, diseases like cystic fibrosis or celiac disease would hamper the absorption of fat-soluble vitamins such as Vitamin A.  
• Infections: Recurrent infection in the child could deplete the vitamin A to fight back that infection.  

Symptoms of xerophthalmia

As said earlier, recognising the symptoms at an early stage can significantly impact the diagnosis and treatment of xerophthalmia. Some of them include:

• Night blindness: If a child complains that it is hard to see in dim light, it is one of the early signs of vitamin A deficiency.  
• Dry eyes: Reduction in tear production is one of the pathologic mechanisms in the development of xerophthalmia. This leads to irritation and a gritty sensation.
• Bitot’s spots: White foamy spots that appear on the cornea and conjunctiva of the eye, which make it hard to see, are a clear indication of vitamin A deficiency.  
• Corneal ulcers: As the inflammation progresses, ulcers are formed at the cornea, which causes immense pain.  
• Perforation: This is the final stage where the corneal perforation occurs, causing blindness.

Stages of xerophthalmia

Xerophthalmia progresses through distinct stages, which are as follows:

• XN: This is a stage of night blindness and the earliest stage.  
• X1A: Conjunctival Xerosis stage where the conjunctival dryness is evident.  
• X1B: Where the Bitot’s spots are seen.  
• X2: Dryness spreads to the cornea, increasing the risk of corneal ulcers.  
• X3A: Corneal ulcers start developing.  
• X3B: The ulcers progress to scarring, leading to an irreversible stage.  
• XS: Scarring obstructs the vision permanently.  
• XF: Xerophthalmic Fundus where the retina is damaged.  

Treatment of xerophthalmia

Early detection could possibly avoid permanent blindness. However, timely treatment can help in preventing such disasters.

• Vitamin A supplementation: The first-line treatment is supplementing the body with vitamin A. High doses of vitamin A are the cornerstone treatment.
• Nutrition: Intake of vitamin A-rich foods along with other vitamins would boost the vision and overall immunity.  
• Management of infections: Recurrent infections should be addressed, and proper management with appropriate medication is essential.
• Eye drops: The dryness of the eye can be treated by using artificially produced tears and glycerine.  
• Surgery: If the child presents with an advanced yet reversible state, surgery could be opted to avoid the progression of the disease.  

Tips for parents

• Ensuring a balanced diet: Always make sure that the child gets adequate amounts of vitamins and minerals from a young age to avoid xerophthalmia.  
• Hygiene: Practising good hygiene activities such as washing hands and cleansing mouth could avoid infections.  
• Regular eye checkups: As the child develops, it is essential to get tested generally to make sure that the vision is adequate and appropriate.  
• Vaccinate against measles: Measle infection could drastically cause vitamin A depletion, resulting in xerophthalmia, and hence, vaccination is of utmost importance.  

Conclusion

Xerophthalmia is a preventable and treatable eye condition, which, if left untreated, can result in permanent blindness and significantly hinder the quality of life. Early detection and treatment is crucial in order to retain the vision. Adequate supplementation of nutrition and vitamins, especially Vitamin A, to prevent the occurrence of xerophthalmia.