- Prevalence of Childhood Blindness and Ocular Morbidity in a Rural Pediatric Population in Southern India: The Pavagada Pediatric Eye Disease Study-1. [Journal Article]
- OEOphthalmic Epidemiol 2016; 23(3):185-92
- CONCLUSIONS: Nearly half of the blindness in the population was due to unavoidable causes (retinal). In addition to providing eye care services, an appropriate service delivery model would include the provision of rehabilitative and low vision services and implementation of genetic studies to understand the causes and increase awareness of inherited eye diseases.
- Vitamin A Deficiency Presenting with 'Itchy Eyes'. [Case Reports]
- CRCase Rep Ophthalmol 2015 Sep-Dec; 6(3):427-34
- We present the case of an 88-year-old female living in metropolitan Melbourne, Australia who developed vitamin A deficiency manifesting as 'itchy eyes' due to a bizarre dietary habit. Slit lamp exami…
We present the case of an 88-year-old female living in metropolitan Melbourne, Australia who developed vitamin A deficiency manifesting as 'itchy eyes' due to a bizarre dietary habit. Slit lamp examination revealed Bitot's spots and a subsequent vitamin A serum level test revealed severe deficiency. An electroretinogram showed grossly reduced a- and b-wave amplitudes consistent with generalised rod and cone dysfunction - these parameters showed marked improvement 5 months post supplementation. This case highlights the presence of vitamin A deficiency in the developed world and that a careful dietary history should be taken when assessing a patient complaining of 'itchy eyes'. Timely diagnosis and treatment may result in dramatic resolution of symptoms and signs as well as prevention of serious morbidity.
- Ophthalmic manifestations of vitamin A and D deficiency in two autistic teenagers: case reports and a review of the literature. [Case Reports]
- CRCase Rep Ophthalmol 2015 Jan-Apr; 6(1):24-9
- We describe the cases of 2 autistic children with ophthalmic and systemic manifestations of vitamin A deficiency due to food faddism. Although vitamin A deficiency is common in the developing world, …
We describe the cases of 2 autistic children with ophthalmic and systemic manifestations of vitamin A deficiency due to food faddism. Although vitamin A deficiency is common in the developing world, reports in developed societies are rare. Our patients presented over a 1-year period. The patients were 14 and 13 years old at the time of presentation and were both found to have marked features of vitamin A deficiency related to unusual dietary habits. Anterior segment signs of xerophthalmia were present in both patients. In addition, patient 1 showed evidence of a rod-predominant retinopathy, which resolved with vitamin A supplementation. Due to its rare occurrence, hypovitaminosis A must be highlighted and anticipated in this cohort.
- Bitot's Spots: Look at the Gut. [Case Reports]
- IJInt J Prev Med 2014; 5(8):1058-9
- Vitamin A deficiency (VAD) can cause a range of ocular manifestations, including night blindness, conjunctival and corneal xerosis and keratomalacia. It is an important cause of preventable blindness…
Vitamin A deficiency (VAD) can cause a range of ocular manifestations, including night blindness, conjunctival and corneal xerosis and keratomalacia. It is an important cause of preventable blindness. Although usually a result of malnutrition, VAD can accompany malabsorption syndrome. We report a case of VAD as manifested by Bitot's spots and eventually diagnosed to have celiac disease. It is, therefore, important to consider gastrointestinal diseases causing malabsorption in the evaluation of VAD.
- Massive dose vitamin A programme in India--need for a targeted approach. [Journal Article]
- IJIndian J Med Res 2013; 138(3):411-7
- The National Prophylaxis Programme against Nutritional Blindness due to vitamin A deficiency (NPPNB due to VAD) was started in 1970 with the specific aim of preventing nutritional blindness due to ke…
The National Prophylaxis Programme against Nutritional Blindness due to vitamin A deficiency (NPPNB due to VAD) was started in 1970 with the specific aim of preventing nutritional blindness due to keratomalacia . The Programme was launched as an urgent remedial measure to combat the unacceptably high magnitude of xerophthalmic blindness in the country seen in the 1950s and 1960s. Clinical VAD has declined drastically during the last 40 years. Also, indicators of child health have shown substantial gains in different States in the country. The prevalence of severe undernutrition has come down significantly. Immunization coverage for measles and other vaccine preventable diseases has improved from 5-7 per cent in early seventies to currently 60-90 per cent, in different States. Similarly, there has been a significant improvement in the overall dietary intake of young children. There has been virtual disappearance of keratomalacia, and a sharp decline in the prevalence of Bitot spots. Prophylactic mega dose administration of vitamin A is primarily advocated because of the claim of 23 per cent reduction in childhood mortality. However, benefits on this scale have been found only in areas with rudimentary health care facilities where clinical deficiency is common, and there is substantial heterogeneity, especially with inclusion of all trials. There is an urgent need for adopting a targeted rather than universal prophylactic mega dose vitamin A supplementation in preschool children. This approach is justified on the basis of currently available evidence documenting a substantial decline in VAD prevalence, substantial heterogeneity and uncertainty about mortality effects in present era with improved health care, and resource constraints with competing priorities.
- Onchocerciasis as a risk factor for night blindness. [Clinical Trial, Phase III]
- OEOphthalmic Epidemiol 2012; 19(4):204-10
- CONCLUSIONS: Onchocercal infection probably accounted for the excess of RNB in this focus.
- Prevalence of ocular signs and subclinical vitamin A deficiency and its determinants among rural pre-school children in India. [Journal Article]
- PHPublic Health Nutr 2012; 15(4):568-77
- CONCLUSIONS: The study revealed that VAD is a major nutritional problem and coverage of VAS was poor. The important determinants of VAD were illiteracy, low socio-economic status, occupation and poor sanitation. Strengthening the existing VAS programme and focused attention on dietary diversification are essential for prevention of VAD.
- Assessment of vitamin A status of preschool children in a sub-Saharan African setting: comparative advantage of modified relative-dose response test. [Journal Article]
- JHJ Health Popul Nutr 2010; 28(5):484-93
- A nationally-representative sample of 2,696 preschool children living in Congo was examined during Au gust-September 2003 to determine the rates of vitamin A deficiency. Ninety clusters of 30 childre…
A nationally-representative sample of 2,696 preschool children living in Congo was examined during Au gust-September 2003 to determine the rates of vitamin A deficiency. Ninety clusters of 30 children, aged six months to six years, were selected, using a randomized two-level cluster-sampling method. Vitamin A deficiency was determined by assessing the prevalence of active xerophthalmia (nightblindness and/or Bitot spots) in the cross-over sample of 2,696 individuals. A semi-quantitative seven-day dietary questionnaire was concurrently applied to the mothers of children enrolled to estimate the latter's consumption of vitamin A-rich food. Vitamin A status was assessed by performing the modified relative dose-response test (MRDR) on dried blood spots (DBS) from a subsample of 207 children aged less than six years and the impression cytology with transfer (ICT) test on a subsample of 1,162 children. Of the children enrolled, 5.2% suffered from nightblindness, 8.0% had Bitot spots, and 2.5% had other vitamin A deficiency sequellae. Fifty-three percent of the ICT tests showed the presence of vitamin A deficiency. The biochemical MRDR test showed that the vitamin A status of 30% of the study children was critical. Twenty-seven of them had retinol levels of < 10 microg/dL [mean +/- standard deviation (SD) 7.02 +/- 2.0 microg/dL], and 50% had retinol levels of 10-20 microg/dL (mean +/- SD 14.2 +/- 2.83 microg/dL). The poor health status and low rates of consumption of vitamin A-rich food are the main factors determining critical status. Vitamin A deficiency, reflecting poor nutrition and health, is a serious public-health issue among children aged less than six years in Congo.
- Antecedent risk factors of xerophthalmia among Indian rural preschool children. [Multicenter Study]
- ECEye Contact Lens 2008; 34(2):106-8
- CONCLUSIONS: The socioeconomic status of families, a history of passing roundworms in stool, and diarrhea were important antecedent risk factors in vitamin A- deficient preschool children. The undisputed long-term solution to prevent this nutrition-related, avoidable blindness lies in changing the dietary habits of the rural Indian population through behavior change communication by nutritional education, nutritional supplementation, and nutritional rehabilitation.
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- Mapping xerophthalmia in Mali: results of a national survey on regional distribution and related risk factors. [Journal Article]
- JAJ Am Coll Nutr 2007; 26(6):630-8
- CONCLUSIONS: This presentation illustrates a public health problem concerning vitamin A deficiency among young children in the general population and allows considering the effectiveness of substitutive intervention with vitamin A capsule distribution along with the improvement of vitamin A rich food production and consumption.