Keratomalacia is a progressive eye disease caused by vitamin A deficiency that can lead to blindness. Treatment involves vitamin A replacement, antibiotics, and lubricating eye drops. Damage to the cornea cannot be reversed, so early detection is crucial. Vitamin A deficiency can be caused by malnutrition or an inability to absorb or convert beta carotene and retinoids.
Keratomalacia is a progressive bilateral eye disease that, if left untreated, can lead to blindness in both eyes. This disease is characterized by the degeneration of the cornea and tear glands. The cause of keratomalacia is vitamin A deficiency. Treatment of the condition typically involves aggressive vitamin A replacement, topical antibiotics to prevent infections in the fragile cornea, and the use of lubricating eye drops to combat dry eyes. Keratomalacia is also sometimes referred to as xerophthalmia or xerotic keratitis.
This eye disease usually begins with clouding and relaxation of the typically hard cornea causing difficulty seeing at night, also known as night blindness. The cornea is the clear, superficial covering of the eye that works with the lens to focus light onto the retina. Changes in the cornea weaken it and make it susceptible to infection and further damage. Eventually, the function of the lacrimal glands, or tear glands, located at the corners of the eye become impaired, resulting in dry eyes. Dry eye can lead to the development of Bitot’s spots, or protein deposits that form in the delicate membrane that covers the sclera, or white part of the eye, further affecting vision.
Damage to the cornea due to keratomalacia cannot be reversed. The only hope of curing this disease is to catch it early enough to prevent further damage and complete loss of vision. Immediate treatment is to augment the diet with vitamin A, beta carotene, and retinoids. This treatment will gradually stop the cornea and tear gland damage.
Additionally, eyes damaged by keratomalacia are usually treated with topical antibiotics to prevent or stem infections common in the damaged cornea. If the damage to the tear glands is advanced enough to cause dry eyes and Bitot’s spots, the eyes will also be treated with lubricating drops to replace the decreased or stopped tear production. When tear gland damage is advanced, it may be necessary to keep the patient in a highly humidified environment to avoid excessive dryness of the eyes.
Vitamin A deficiency can have many causes. This vitamin insufficiency can be the result of starvation or malnutrition when food supplies or varied and nutritious foods are limited. Vitamin A deficiency can also be caused by not eating foods rich in beta carotene, such as green leafy or orange-colored vegetables and fruits, and retinoid-rich foods such as liver and eggs. Beta carotene and retinoids are transformed into vitamin A in the body. Vitamin A deficiency can also be caused when the body is unable to absorb beta carotene or retinoids or is unable to convert beta carotene or retinoids into vitamin A.
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