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Results for “XEROPHTHALMIA”

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PubMed1999

Prevalence of xerophthalmia among children in Beheira governorate, Egypt.

A survey was conducted on a sample representative of the entire Beheira governorate to identify high-risk areas of vitamin A deficiency (VAD) and assess xerophthalmia prevalence. The study also tested the reliability of a household cluster survey for assessing xerophthalmia prevalence. A trained ophthalmologist examined 10,664 children. The results showed that VAD was present in the region, but did not appear to be a public health problem. Ocular signs of VAD were more prevalent among older children, suggesting an improvement in socioeconomic conditions and health care over the past few years. The household cluster survey appeared to be a reliable method for assessing xerophthalmia prevalence in the region.

Age Distribution↗

PubMed1998

[Reconstructive lacrimal gland with free submandibular gland transfer for management of xerophthalmia].

OBJECTIVE: In order to seek more efficient surgical method to treat total xerophthalmia. METHOD: Microvascular submandibular gland transfer was used to reconstruct lacrimal gland for management of the dry eye. 5 cases (6 eyes) with total xerophthalmia were operated with this method. RESULTS: All the patients were followed up for 1 - 30 months. The results were satisfactory, the submandibular salivary gland relieved the dryness and improved visual acuities with negligible side effect. CONCLUSION: Microvascular submandibular gland transfer is potentially the best surgical solution to total xerophthalmia.

Adolescent↗

PubMed2006

[Clinical observation on the method for nourishing blood and moisturizing eye on xerophthalmia].

OBJECTIVE: To observe therapeutic effect of the method for nourishing blood and moisturizing eye on xerophthalmia. METHODS: Fifty-one cases of xerophthalmia were randomly divided into a treatment group and a control group. The treatment group were treated by acupuncture, moxibustion with Chinese medicine, and auricular point pressing, and the control group were treated with dripping of artificial tears. Local symptoms of eyes, tear secretion amount (Schirmer method) and BUT were observed before and after treatment. RESULTS: The total effective rate of 88.5% in the treatment group was better than 52.0% in the control group (P<0.05). CONCLUSION: The method for nourishing blood and moisturizing eye is a better therapy for xerophthalmia.

Acupuncture↗

PubMed1994

Changing prevalence of xerophthalmia in Indonesia, 1977-1992.

OBJECTIVE: The primary objective of this analysis was to determine if the prevalence of xerophthalmia in Indonesia has changed over the period 1977-78 to 1992. DESIGN: The design was two cross-sectional prevalence surveys conducted in the same rural sample locations 14 years apart. SETTING: The studies were conducted in 15 provinces of Indonesia using a stratified random selection of villages. SUBJECTS: All persons in selected villages < 6 years of age were eligible for participation. Children were recruited during a door-to-door census of villages and invited to present for an eye examination at a central point in the village. A total of 19,032 subjects were included in the 1977-78 and 18,508 children in the 1992 survey. RESULTS: Overall, the prevalence of active xerophthalmia among preschool children declined by 75% (1.33% in 1977-78 to 0.34% in 1992). Active corneal disease declined by 95% (1/1000 in 1977-78 to 0.05/1000 in 1992). While the overall declines were dramatic and highly significant (P < 0.0001), selected provinces continued to show rates higher than the WHO criteria for a problem of public health significance. CONCLUSIONS: The prevalence of xerophthalmia has declined significantly over the past 14 years in Indonesia. The specific reasons for this decline cannot be ascribed to any particular intervention due to the multitude of health and social changes that have occurred during this period.

Child, Preschool↗

PubMed1988

Impact of vitamin A supplementation on xerophthalmia. A randomized controlled community trial.

The value of biannual distribution of 200,000 IU of vitamin A in preventing xerophthalmia was assessed in a randomized, controlled community-based trial involving 25,000 preschool children in 450 villages of northern Sumatra. Results indicate that distribution was associated with a dramatic decline in xerophthalmia prevalence; that concurrent controls were critical for distinguishing spontaneous from program-related changes; and that the apparent level of benefit depended on the choice of clinical indicator(s). Night blindness ceases to be an accurate reflection of impact when prevalence rates are low, and comparison of Bitot's spot rates should be confined to new cases of disease.

Child, Preschool↗

PubMed1990

Xerophthalmia and cystic fibrosis.

We treated two infants with failure to thrive who presented with clinical evidence of conjunctival and corneal xerosis. One patient was referred with possible infectious corneal ulcer thought to exist because there were deep peripheral ulcerations of the cornea and associated hypopyon. The other patient was initially thought to have a nasolacrimal duct obstruction because of excessive tearing. Xerophthalmia secondary to vitamin A deficiency was suspected and led to the diagnosis and treatment of cystic fibrosis in each case. Therapy with vitamin A promptly resolved the xerosis, but it also caused a transient rise in intracerebral pressure. Xerophthalmia can still be a problem in developed countries when underlying disorders, such as cystic fibrosis, lead to vitamin A malabsorption.

Cystic Fibrosis↗

PubMed1990

Xerophthalmia, keratomalacia and nutritional blindness.

Vitamin A deficiency remains a major cause of pediatric ocular morbidity. Over five million children develop xerophthalmia annually, a quarter million or more becoming blind. It is also a major pathway for measles-associated blindness, particularly in Africa. Treatment is practical and inexpensive, based upon the oral administration of 200,000 IU vitamin A on two successive days, at a cost of 10 cents U.S. Given the potential rapidity of corneal necrosis (keratomalacia) and the relative inaccessibility of health services to those at greatest risk, prevention is probably more important than treatment. Oral administration of high dose supplements (2000,000 IU every 3 to 6 months), vitamin A fortification of commonly consumed items, or best of all, increased dietary intake of natural sources of vitamin A will reduce the number of needlessly blind young children. Given recent evidence that vitamin A deficiency greatly increases overall mortality, even among children without evidence of xerophthalmia, the same prophylactic regimen may improve child survival by 35% or more.

Blindness↗

PubMed1992

Impression Cytology with Transfer in xerophthalmia and conjunctival diseases.

During a countrywide survey, we assessed the prevalence of clinical signs of xerophthalmia and of major conjunctival diseases in a randomized sample of 2,445 subjects representative of the population of the Republic of Djibouti. On a part of this sample, conjunctival Impression Cytology with Transfer (ICT) test and a plasma retinol determination were performed. Xerophthalmia as a public health problem was displayed by clinical signs (Bitot's spots, corneal scars among preschool children), low plasma retinol levels and ICT test results: 9.3% with deficient cytology in the rural area and 12.3% in the urban one (age-standardized rates). Results of ICT were related to age (p < 0.00001). Vitamin A deficiency was prevalent not only in preschool children but also up to 15 years. Moreover, ICT results are influenced by conjunctival diseases: compared to age-matched controls, there were more abnormal cytologies among patients with trachomatous inflammation (p = 0.025), conjunctivitis (p = 0.024) or Limbal Vernal Keratoconjunctivitis (p = 0.015). Thus ICT shouldn't be performed among children with conjunctival diseases. In the region under study conjunctival diseases had high rates of prevalence: 16.4% of trachomatous scarrings in the urban area (standardized rate), 8% of conjunctivitis among rural preschool children, and 5% of Limbal Vernal Keratoconjunctivitis among children between 5 and 14 years in both areas.

Adolescent↗

PubMed1979

Vitamin A-responsive punctate keratopathy in xerophthalmia.

Slit-lamp examination of 78 cases of xerophthalmia and 29 controls matched for age, sex, and locale indicated a direct correlation between the presence, density, and extent of punctate epithelial keratopathy and the severity of corneal and noncorneal involvement. Only 7% (four or 58) of control eyes but 60% (six of ten) of cases with confirmed night blindness, 75% (47 of 63) of eyes with conjunctival xerosis, and all eyes with corneal xerosis (47) were affected. Within one week of high-dose systemic vitamin A therapy all affected corneas had improved. None of ten patients receiving low-dose systemic therapy showed any improvement over a two-month period, whereas 61% of involved corneas actually deteriorated in the interim. Punctate epithelial keraptopathy appears to be the earliest corneal manifestation of xerophthalmia, and is already present in the vast majority of cases classically considered free of corneal involvement.

Administration, Oral↗

PubMed1982

Tear production in vitamin A-responsive xerophthalmia.

Schirmer tests showed decreased tearing (less than 15 mm of wetting) in 32 of 54 eyes (59%) of a representative group of patients with corneal xerophthalmia but in only four of 60 eyes (7%) of age-, sex-, and neighborhood-matched controls (P less than .001). The occurrence of decreased tearing was directly related to protein status: eight of 18 eyes (44%) of children with serum transferrin levels below 50 mg/100 ml but only 13 of 62 eyes (21%) of children with higher levels produced less than 15 mm of wetting (P less than .01). Among otherwise well-nourished children, the occurrence of decreased tearing was directly related to the severity of xerophthalmia and thus to vitamin A status. We found decreased tearing in eight of 86 eyes (9%) of a group of unpaired controls, in nine of 38 eyes (24%) of children with conjunctival xerosis, and in 17 of 62 eyes (27%) of children with corneal involvement (P less than .01).

Child↗

PubMed1991

Long term results of submandibular gland transfer for the management of xerophthalmia.

Free submandibular gland transfer is potentially the best surgical solution to total xerophthalmia. Experimentally, gland function has only previously been followed for 2 months. This study was designed to investigate the long term effects of free transfer on gland function. Simultaneous creation of experimental xerophthalmia and free microvascular transfer of the submandibular gland to the orbit was completed in 10 rabbits. Two died before the end of the experimental period and the study was based on the remaining eight. Six months after transfer, five of the eight transferred glands were histologically normal and contained healthy neurones and nerve terminals. In these animals, tear secretion in the transfer eye was significantly greater than that of the control eye at 2 (p less than 0.05) and 6 months (p less than 0.02) after transfer. In the transfer eye, tear secretion was also found to have significantly increased from preoperative levels at 2 (p less than 0.05) and 6 months (p less than 0.01). The observed innervation of the transferred glands may play a role in maintaining secretion in the long term.

Animals↗

PubMed2004

[Usefulness of oral pilocarpin therapy in the treatment of xerostomia and xerophthalmia in patients with primary Sjögren's syndrome].

BACKGROUND AND OBJECTIVE: We aimed to asses the efficacy of pilocarpine tablets as a symptomatic treatment for dry mouth and dry eyes in patients with primary Sjögren's syndrome (SS). PATIENTS AND METHOD: We included 40 patients with SS (38 women and 2 men), mean age 49.2 years (range, 35-68), with severe xerostomia and xerophthalmia. Objective tests (salivary scintigraphy, Schirmer's test, break-up time, Rose Bengal staining) and subjective tests (symptoms' questionnaire) were carried out before starting treatment and 6 months later to evaluate any glandular function improvement. RESULTS: All patients initially received 15 mg daily of pilocarpine. Twelve (30%) patients received 20 mg daily. Dry mouth-related symptoms improved in 57.5% of patients and dry eyes-related ones improved in 35%. Scintigraphic studies demonstrated an objective improvement of the glandular function in 35% patients. Ocular tests showed an improvement in 30% cases. CONCLUSIONS: Pilocarpine therapy is useful to improve xerostomia and xerophthalmia in SS patients with moderate and severe glandular involvement. However, we have not observed a good correlation between subjective improvement of symptoms and the objective test results.

Administration, Oral↗

PubMed1980

Oral versus intramuscular vitamin A in the treatment of xerophthalmia.

In a controlled trial 69 children with corneal xerophthalmia were given 200 000 IU oil-miscible vitamin A by mouth and a matched group of 45 children were given 100 000 IU water-miscible vitamin A intramuscularly. Both groups received an additional oral dose the next day. There was no detectable difference in the clinical response to the two regimes, even when analysis was limited to patients with concomitant diarrhoea or protein-energy malnutrition. Although serum-vitamin-A levels were significantly higher after parenteral than oral therapy, holoretinol-binding-protein levels were not. Oral administration of vitamin A is not only more practical but appears to be just as effective as parenteral administration in the treatment of severe xerophthalmia.

Administration, Oral↗

PubMed1998

Xerophthalmia and vitamin A status.

The existence of 'fat-soluble A' has been known for over 80 years. But until recently clinicians were almost wholly absorbed by the ocular changes accompanying deficiency (xerophthalmia), and scientists with the vitamin's metabolic role in the rhodopsin cycle. The past two decades have witnessed a revolution in clinical and scientific concerns. Xerophthalmia is now recognized as a late manifestation of severe deficiency rather than of early, mild deficiency; as the mechanism responsible for half or more of all measles-associated blindness; and as the cause of half a million or more cases of pediatric blindness worldwide. Milder deficiency increases the severity of infectious morbidity, exacerbates iron deficiency anemia, retards growth, and is responsible for one to three million childhood deaths each year. Scientists are now busy unraveling vitamin A-dependent gene regulation to explain the myriad manifestations accompanying deficiency, while clinicians are designing and supervising programs to improve vitamin A status in over 60 countries, up from only three countries two decades ago. Control of vitamin A deficiency is now a major health challenge and goal of both UNICEF and the World Health Organization (WHO). Reaching that goal requires better parameters for assessing vitamin A status, increased understanding of metabolic pathways responsible for corneal dissolution (keratomalacia) and the molecular and cellular basis by which vitamin A status mediates resistance to infection. These issues are detailed elsewhere (Sommer and West, 1996).

Animals↗

PubMed2000

[Two patients with xerophthalmia].

BACKGROUND: Xerophthalmia, the eye manifestation of vitamin A deficiency, is one of the main reasons of blindness in developing countries but is rare in industrial countries. PATIENTS: We report on 2 cases of night blindness and conjunctival and corneal xerosis because of hypovitaminosis A. One patient developed vitamin A deficiency due to short bowel syndrome resulting from gastroschisis. The other patient suffered from primary hypovitaminosis A because of malnutrition due to inadequate dietary intake. Electroretinograms were consistent with vitamin A deficiency. Their symptoms quickly improved after vitamin A substitution. CONCLUSION: Although rare in developed countries, ophthalmologists should consider xerophthalmia as differential diagnosis in night blindness and conjunctival and corneal xerosis. Early diagnosis and adequate treatment can prevent permanent visual loss.

Adult↗

PubMed1982

Dietary practices and xerophthalmia among Indonesian children.

The stated frequency with which 30 Indonesian children with corneal xerophthalmia and age/sex/neighborhood matched controls ordinarily consumed vitamin- and provitamin A-rich foods was compared. Controls were more frequent consumers of eggs (p less than 0.05), fish (p less than 0.05), dark green leafy vegetables (p less than 0.05), carrots (p less than 0.01), and carotene-containing fruits (p less than 0.1). Similar data were collected on 358 children with Bitot's spots and on normal preschool age children in a countrywide survey. Breast-feeding was more common among normals than among cases (p less than 0.001). Normals were also more frequent consumers of mango and papaya during the 2nd and 3rd yr of life (p less than 0.05); and of dark green leafy vegetables and eggs during the 3rd through 6th yr of life (p less than 0.01). In two separate studies, differences in carotene consumption by normals and abnormals were confirmed by differences in their serum carotene levels. Approximately 80% of Indonesian families, with an without xerophthalmic children, consumed dark-green leafy vegetables at least once a day, and 99% at least once a week. Diet therefore appears to be an important factor in the genesis of xerophthalmia in Indonesia despite the availability of suitable provitamin A-rich foods.

Age Factors↗

PubMed1987

Increased risk of xerophthalmia following diarrhea and respiratory disease.

Preschool-age rural Indonesian children were reexamined every 3 mo for 18 mo. An average of 3228 were free of xerophthalmia at the examination initiating each of the six, 3-mo follow-up intervals. Children with respiratory disease and/or a recent history of diarrhea at the start of an interval developed xerophthalmia by the end of the interval at more than twice the rate of their healthier peers (p less than 0.05) independent of anthropometric status. It appears that vitamin A deficiency and infections, especially diarrhea and respiratory disease, can establish a vicious cycle that induces and perpetuates ocular and systemic disease.

Child, Preschool↗

PubMed1989

Vitamin A activity of buriti (Mauritia vinifera Mart) and its effectiveness in the treatment and prevention of xerophthalmia.

The fruit of buriti, a palm tree that grows wild in some regions of Brazil, contains beta-carotene in its oily fraction in a concentration 10 times higher than that of red-palm oil. The effectiveness of buriti sweet in the treatment and prevention of xerophthalmia was tested in 44 children aged 43-144 mo through daily supplementation with an amount corresponding to 134 micrograms retinol equivalent over 20 d. The results demonstrated that this natural food source of vitamin A can reverse clinical xerophthalmia and restore liver reserves of the vitamin, suggesting its possible utilization in intervention programs to combat vitamin A deficiency in countries where the fruit is available or has the potential for cultivation.

Brazil↗