Faculty of Public Health - Andalas University - OCS, 13th IEA SEA Meeting and ICPH - SDev

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A CASE REPORT –VITAMIN A DEFICIENCY WITH BITOT’S SPOTS
Garima Sangwan

Last modified: 2018-08-14

Abstract


Background

Vitamin A deficiency manifests as night blindness, conjunctival xerosis, Bitot's spot, corneal xerosis, and corneal ulceration. Currently, it is estimated that there are about 1.5 million blind children in the world, of whom one million live in Asia. Every year there are half a million new cases, 70% of which are due to VAD which leads to Xerophthalmia.  Children are at higher risk owing to their greater vitamin A requirements for growth, intestinal infestations and infections, which may impair the absorption of vitamin A.

Case Report

A five years old female resident of Kalaamb area, Haryana and migrant from Bihar presented with chief complaints of decreased vision during night for past one month. On examination both the eyes had a visual acuity of 6/9 and bilateral bitot's spots were seen temporally on bulbar conjunctiva. She was treated with oral vitamin A supplementation of 2 lac IU on day 0,1 & 14. On follow upafter a month, the child’s symptoms improved and bitot’s spots resolved completely. Patient will further be followed up for six months.

Conclusions

Non-ocular changes of vitamin A deficiency are largely hidden. All ocular manifestations of Vitamin A deficiency usually respond rapidly to vitamin A therapy. Bitot’s spots resolve completely in 35% of the cases. Early detection and prompt treatment is the only way to prevent Xerophthalmia and its complications. Treatment done at primary care level is very impactful for vitamin A deficiency disorders.

Keywords

Xerophthalmia, bitots spots, vitamin A deficiency, pediatric, ocular.