Keratomalacia is hastened by protein-caloric malnutrition, and can be precipitated by a systemic illness such as measles, pneumonia or diarrhoea.
Usually occurs as a result of vitamin A deficiency (commonest cause worldwide), secondary to inadequate diet, cystic fibrosis , sprue or other causes of malabsorption of fat soluble vitamins (IBD, liver disease , intestinal bypass surgery).
Keratomalacia is the softening and drying and ulceration of the cornea resulting from vitamin A deficiency; symptom of cystic fibrosis or sprue
Vitamin A is essential for normal vision as well as proper bone growth, healthy skin, and protection of the mucous membranes of the digestive, respiratory, and urinary tracts against infection.
In some developing countries, vitamin A deficiency in the diet and associated keratomalacia are a major cause of childhood blindness. In such regions, vitamin A deficiency often occurs as part of nonselective general malnutrition in infants and young children.
Lack of tears causes extreme dryness of the eyes, and foamy Bitot's spots appear on the bulbar conjunctiva.
Symptoms of Keratomalacia
Early symptoms may include
- poor vision at night or in dim light (night blindness)
- and extreme dryness of the eyes (i.e., xerophthalmia), followed by wrinkling, progressive cloudiness, and increasing softening of the corneas (i.e., keratomalacia).
Treatment of Keratomalacia
Diet supplements rich in vitamin A or beta-carotene should be provided in high risk areas to prevent the condition (NB vitamin A should be avoided during pregnancy because of the risk of vitamin A embryopathy).
Keratomalacia is irreversible and causes permanent corneal scarring. Vitamin A therapy and a protein-rich diet are essential.
Topical antibiotics are given to prevent secondary bacterial infection.