Xerophthalmia.pptx

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 D iarrhoea , dehydration and electrolyte imbalance I nfections 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