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close this bookWhere There Is No Doctor - A Village Health Care Handbook (Hesperian Foundation, 1993, 516 p.)
close this folderChapter 16 - THE EYES
View the document(introduction...)
View the documentDanger Signs
View the documentInjuries to the Eye
View the documentHow to Remove a Speck of Dirt from the Eye
View the documentChemical Burns of the Eye
View the documentRed, Painful Eyes - Different Causes
View the document‘Pink Eye’ (Conjunctivitis)
View the documentTrachoma
View the documentInfected Eyes in Newborn Babies (Neonatal Conjunctivitis)
View the documentIritis (Inflammation of the Iris)
View the documentGlaucoma
View the documentInfection of the Tear Sac (Dacryocystitis)
View the documentTrouble Seeing Clearly
View the documentCross-Eyes and Wandering Eyes
View the documentSty (Hordeolum)
View the documentPterygium
View the documentA Scrape, Ulcer, or Scar on the Cornea
View the documentBleeding in the White of the Eye
View the documentBleeding behind the Cornea (Hyphema)
View the documentPus Behind the Cornea (Hypopyon)
View the documentCataract
View the documentNight Blindness and Xerophthalmia (Vitamin A Deficiency)
View the documentSpots or 'Flies' before the Eyes (Mouches Volantes)
View the documentDouble Vision
View the documentRiver Blindness (Onchocerciasis)
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Night Blindness and Xerophthalmia (Vitamin A Deficiency)

This eye disease is most common in children between 1 and 5 years of age. It comes from not eating enough foods with vitamin A. If not recognized and treated early, it can make the child blind.


· At first, the child may have night blindness. He cannot see as well in the dark as other people can. (1)


· Later, he develops dry eyes (xerophthalmia). The white of the eyes loses its shine and begins to wrinkle. (2)

· Patches of little gray bubbles (Bitot's spots) may form in the eyes. (3)


· As the disease gets worse, the cornea also becomes dry and dull, and may develop little pits. (4)


· Then the cornea may quickly grow soft, bulge, or even burst. Usually there is no pain. Blindness may result from infection, scarring, or other damage. (5)


· Xerophthalmia often begins, or gets worse, when a child is sick with another illness like diarrhea, whooping cough, tuberculosis, or measles. Examine the eyes of all sick and underweight children. Open the child's eyes and look for signs of vitamin A deficiency.

Prevention and treatment:

Xerophthalmia can easily be prevented by eating foods that have vitamin A. Do the following:


· Breast feed the baby - up to 2 years, if possible.

· After the first 6 months, begin giving the child foods rich in vitamin A, such as dark green leafy vegetables, and yellow or orange fruits and vegetables such as papaya (paw paw), mango, and squash. Whole milk, eggs, and liver are also rich in vitamin A.

· If the child is not likely to get these foods, or if he is developing signs of night blindness or xerophthalmia, give him vitamin A, 200,000 units (60 mg. retinol, in capsule or liquid) once every 6 months. Babies under 1 year of age should get 100,000 units.

· If the condition is already fairly severe, give the child 200,000 units of vitamin A the first day, 200,000 units the second day, and 200,000 units 14 days later. Babies under 1 year old should get half that amount (100,000 units).

· In communities where xerophthalmia is common, give 200,000 units of vitamin A once every 6 months to women who are breast feeding, and also to pregnant women during the second half of their pregnancy.

WARNINGS: Too much vitamin A is poisonous. Do not give more than the amounts advised here.

If the condition of the child's eye is severe, with a dull, pitted, or bulging cornea, get medical help. The child's eye should be bandaged, and he should receive vitamin A at once, preferably an injection of 100,000 units.

Dark green leafy vegetables, and yellow or orange fruits and vegetables, help prevent blindness in children.