Vitamin A Deficiency & Childhood blindness

Optom
Vitamin A Deficiency in children is the lack of Vitamin A in their body to a point of creating functional changes & creating disease conditions in their human system.
Vitamin A deficiency, though it can affect adults, results in horrific ocular & immunologic consequences especially in children. It is both a precursor to measles & aggrevated by measles! It causes corneal blindness in children, especially those in developing countries like Africa & Asia.
Other ocular implications include Xerophthalmia (secondary to reduced presence & influence of meibomian gland & other secretory apparatus in the eyes), then chronic corneal ulceration followed by Keratomalasia & subsequent anterior Staphyloma. Night blindness, or Nyctalopia is usually the first implication of this condition. In Vitamin A deficiency, it involves the inability of the Rhodopsin to be ibe formed because Vitamin A which is the primary source of retinal (a Vitamin A precursor for Rhodopsin formation with the contributions of light sensitive opsin proteins! Nyctalopia can also be caused by a genetic condition known as Retinitis Pigmentosa, or could be attributed to genetic deficiency of the rods to function beyond threshhold but does not progress like the Retinitis Pigmentosa. This later condition is known as X-link congenital Stationary Night blindness.
  Vitamin A deficiency (VAD) in children and pregnant women causes a weakness of the human immune system and has hence become implicated in low body defence response to diseases like measles & also to other bacterial infections, not common in healthy individuals! VAD affects 1 in every 3 children as at 2008! It is reported that between 250,000-500,000 children become blind annually as a result of VAD and half of these children die within 1 year of becoming blind. With the combined help of World Health Organization, United States Agency for International Development, Canadian International Developmental Agency and Micronutrient initiative under the umbrella of Vitamin A Global Initiative has been able to avert about 1.25 million deaths in about 40 countries since 1998! The year 2010 was put forward as the year VAD should be eliminated in the general population, but we are yet to see the end of this child-killer disease!
 In Nigeria, Xerophthalmia was estimated to be 1.1 % prevalent in the children population and 7% have VAD (Ajayeoba A.I., 2001). Xerophthalmia describes the ocular manifestations of VAD. It is estimated, by projection, that about 1 million children are affected by VAD and about 100,000 could have an eye involvement (Xerophthalmia) and 50,000 may go blind while 25,000 children are estimated to die annually (Sommers, 1995). This condition is more prevalent in the northwest but least prevalent in the southeast! I think dietary differences play a role here and such findings should be varified by Optometric study nationally!
Treating VAD is done using Vitamin A supplementation therapy and managing the systemic effect like Diarrhea, Measles etc. If there is any ocular effect, it is most appropiate to manage the Xerophthalmia in its early stages when the cornea is not affected! It is best treated with Ocular lubricants, while such conditions like corneal ulceration is best managed with non steroidal anti inflamatory agents like Diclofenac Sodium, others includes topical antibiotic agents like Ciprofloxacin and chloramphenicol ointment! Look out for any corneal involvement in any reported case VAD! It could save that child's sight! It is very appropiate to educate pregnant women and lactating mothers on the need to avoid getting VAD. In these group of people, bilateral blindness could result! Treat them in conjunction with their Gynacologists/Obestricians. Their kind of blindness is retinal in nature!
VAD is a public health issue and Optometrists are adviced to contribute to eliminating this condition! Lets make the future of our children stress free because they are the leaders of tommorrow! Lets make vision 2020 a reality. I know we can. Happy December and Christmas in advance!