Question

what is the definetion of xerophthalmia?

what are the Causes of xerophthalmia?

what are the Incidence of xerophthalmia?

what are the Clinical Features for xerophthalmia?

what are the Diagnostic investigation for xerophthalmia?

what are the Medical management of xerophthalmia?

what are the Nursing management for xerophthalmia?

what are the Prevention for xerophthalmia?

what are the Complications for xerophthalmia?

Answer 1

what is the definetion of xerophthalmia?

Xerophthalmia (from Ancient Greek "xērós" meaning "dry" and "ophthalmos" (οφθαλμός) meaning "eye") is a medical condition in which the eye fails to produce tears.

The term xerophthalmia covers all the ocular manifestations of vitamin A deficiency. Xerophthalmia can progress to irreversible blindness if left untreated.

In endemic areas, vitamin A deficiency and xerophthalmia affect mainly children (particularly those suffering from malnutrition or measles) and pregnant women.

Disorders due to vitamin A deficiency can be prevented by the routine administration of retinol.

what are the Causes of xerophthalmia?

The condition is not congenital and develops over the course of a few months as the lacrimal glands fail to produce tears. Other conditions involved in the progression already stated include the appearance of Bitot's spots, which are clumps of keratin debris that build up inside the conjunctiva and night blindness, which precedes corneal ulceration and total blindness.

Etiology •

Vitamin A deficiency

1. Dietary deficiency-less intake,severe dieting

2. Defective metabolism -malabsorption -malnutrition -chronic alcoholism Associated with PEM and infections esp in children

what are the Incidence of xerophthalmia?

The incidence of xerophthalmia in the rural population was found to be 9.5% but the incidence in children below the age of 5 years was 7.4%.The incidence of xerophthalmia in the rural population was found to be 9.5% but the inci­dence in children below the age of 5 years was 7.4%.In incidence of xerophthalmia in children below the age of 5 years was approximately 13%. Out of 739 children attending the Paediatrics, O.P.O. only 52 cases (7.03%) found to have signs of xerophthalmia, whereas the incidence of xerophthalmia in children attending the Eye O.P.D. was 34.24%.

what are the Clinical Features for xerophthalmia?

The first sign is hemeralopia (crepuscular blindness): the child cannot see in dim light, may bump into objects and/or show decreased mobility.

– Then, other signs appear gradually:
• Conjunctival xerosis: bulbar conjunctiva appears dry, dull, thick, wrinkled and insensitive
• Bitot’s spots: greyish foamy patches on the bulbar conjunctiva, usually in both eyes (specific sign, however not always present)
• Corneal xerosis: cornea appears dry and dull
• Corneal ulcerations
• Keratomalacia (the last and most severe sign of xerophthalmia): softening of the cornea, followed by perforation of the eyeball and blindness (extreme care must be taken during ophthalmic examination due to risk of rupturing cornea)

what are the Diagnostic investigation for xerophthalmia?

Lissamine Green Staining in the Clinical Diagnosis of Xerophthalmia

Lissamine green staining of the conjunctiva, a new and widely heralded aid for diagnosing early xerophthalmia, was found to be a reasonably specific but inadequately sensitive test for practical use. While 82% of clinically normal children failed to show staining, so did 57% with night blindness, 29% with vitamin A responsive Bitot's spots, and, most significantly, 26% with severe, vitamin A related corneal involvement. The test also failed to distinguish vitamin A responsive "Bitot's spots" from nonresponsive ones.

what are the Medical management of xerophthalmia?

reat early symptoms to avoid the development of severe complications. Vision can be saved provided that ulcerations affect less than a third of the cornea and the pupil is spared. Even if deficiency has already led to keratomalacia and irreversible loss of sight, it is imperative to administer treatment, in order to save the other eye and the life of the patient

Retinol (vitamin A) PO
Regardless of the clinical stage:
Children from 6 to 12 months (or under 8 kg): 100 000 IU once daily on D1, D2 and D8
Children over 1 year (or over 8 kg): 200 000 IU once daily on D1, D2 and D8
Adults (except pregnant women): 200 000 IU once daily on D1, D2 and D8
Vitamin A deficiency is rare in breast fed infants under 6 months, if needed: 50 000 IU once daily on D1, D2 and D8.

In pregnant women, treatment varies according to the stage of illness:
• Hemeralopia or Bitot's spots: 10 000 IU once daily or 25 000 IU once weekly for at least 4 weeks. Do not exceed indicated doses (risk of foetal malformations).
• If the cornea is affected, risk of blindness outweighs teratogenic risk. Administer 200 000 IU once daily on D1, D2 and D8.

– Corneal lesions are a medical emergency. In addition to the immediate administration of retinol, treat or prevent secondary bacterial infections with 1% tetracycline eye ointment, one application 2 times daily (do not apply eye drops containing corticosteroids) and protect the eye with an eye-pad after each application.

what are the Nursing management for xerophthalmia?

care during hospitalisation

taught parents regarding the preventive measures of xerophthalmia along with the administration of vitamin A among children under 5 year

promote regular and adequate intake of vitamin A ans immunization against common childhoodinfectious diseases.

promotion of breastfeeding

improve health service to mother and small children

what are the Prevention for xerophthalmia?

Prophylaxis consists of periodic administration of Vitamin A supplements. WHO recommended schedule, which is universally recommended is as follows:

• Infants 6–12 months old and any older children weighing less than 8 kg – 100,000 IU orally every 3–6 months
• Children over 1 year and under 6 years of age – 200,000 IU orally every 6 months
• Infants less than 6 months old, who are not being breastfed – 50,000 IU orally should be given before they attain the age of 6 months

what are the Complications for xerophthalmia?

The major risk for xerophthalmia is poverty and lack of adequate diet, especially a lack of animal products. Infants and children are at greater risk. The younger the child, the more severe the effects of vitamin A deficiency.

Children require a lot of vitamin A in order to grow. Vitamin A deficiency also affects the ability to survive common childhood infections and diseases, such as diarrhea, measles, and respiratory infections.

Other risk factors affect a much smaller number of people in the United States and other countries. The following are risk factors because they affect a person’s ability to absorb vitamin A:

• alcoholism
• cystic fibrosis
• diseases such as celiac disease that limit the absorption of nutrients
• liver disease, such as cirrhosis
• chronic diarrhea
• radioiodine treatment for thyroid cancer, which may produce nonpermanent symptoms of xerophthalmia