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Everything You Need to Know About Xerophthalmia

Xerophthalmia is an eye condition that results from vitamin A deficiency. Symptoms include dry eyes, night vision difficulty, and lesions on the eyeball’s mucous membrane.Treatment for xerophthalmia can involve increasing your vitamin A intake or using artificial tears. Some people may require surgery.

According to the National Institutes of Health, vitamin A deficiency is one of the most common causes of preventable blindness in children. Promptly addressing a vitamin A deficiency is critical to preventing complications.

This article will explain xerophthalmia, including its symptoms and causes. It will also discuss the diagnostic and treatment methods for the condition.

What are the causes of xerophthalmia?

Xerophthalmia results when you eat too little vitamin A. It can also happen if your body is unable to absorb the nutrient.

Vitamin A is essential for vision. It is a component of rhodopsin, an eye protein that enables you to see in dim light. It also helps keep the outside covering of your eyes clear.

Common sources of vitamin A include green leafy vegetables, meats, and fish.

Many factors can cause vitamin A deficiency, including:

  • Poverty: This is a common cause of malnutrition and nutrient deficiencies, especially in developing countries.

  • Alcohol misuse: Excessive alcohol consumption can contribute to malnutrition and nutrient deficiencies.

  • Cystic fibrosis: This is a genetic condition that causes infections and lung damage. It can also reduce the body’s ability to absorb nutrients from food.

  • Celiac disease: This is an autoimmune disorder that results from eating gluten. It can cause chronic digestive problems and prevent your body from getting the nutrients it needs.

  • Bile duct blockage: This is when one of the tubes that transports bile between the liver and other organs becomes blocked. It can interfere with the balance of nutrients in the body.

  • Cirrhosis: This condition occurs when scar tissue replaces healthy liver tissue, causing permanent liver damage. It can affect the way your body absorbs nutrients.

  • Chronic diarrhea: Chronic diarrhea can contribute to malnutrition, reducing nutrient absorption and increasing the breakdown of nutrient reserves.

What are the symptoms of xerophthalmia?

Xerophthalmia is a progressive condition. This means that without treatment, symptoms will typically get worse with time.

The progression usually happens as follows:

  1. The tear ducts become dry.

  2. The eyeball and eyelid also become dry and develop a wrinkled appearance.

  3. Night blindness develops, which is an inability to see clearly in dim light.

  4. White lesions known as Bitot’s spots form on the surface of the eyeball.

  5. Ulcers develop on the cornea, which is the outer layer of the eye.

  6. The cornea‌ becomes scarred and permanently damaged.

Contact your doctor if you have symptoms of xerophthalmia.

How do doctors diagnose xerophthalmia?

To diagnose xerophthalmia, your doctor will ask you questions related to your symptoms, medical history, and eating habits. They may also conduct a lab test to check the levels of vitamin A in your body.

Other possible tests include:

  • Dark adaptometry: This test can help detect problems with the retina. The retina is the thin layer of tissue that lines the back of the eye on the inside. The test works by evaluating how well the eye recovers its light sensitivity after exposure to bright light.

  • Night vision threshold tests: Doctors can use this test to detect night blindness. It works by evaluating the eye’s dark adaptation. This is the ability of the eye to become more visually sensitive after long-term exposure to darkness.

  • Impression cytology: An impression cytology test can detect diseases in the outer layer of the eye. It uses cellulose acetate to collect eye surface cells for further analyses.

  • Electroretinogram: This test can detect atypical retina behavior. It measures the electrical responses of various cell types in the retina.

What are the treatments for xerophthalmia?

Xerophthalmia treatment typically focuses on increasing the levels of vitamin A in your body. Your doctor may give you vitamin A supplements by mouth or injection.

Your doctor may also recommend:

  • using preservative-free artificial tears to treat dry eyes

  • taking antibiotics to prevent or treat secondary bacterial infections

  • consuming vitamin A-rich foods to boost your vitamin A stores

  • keeping the home humidified and wearing sunglasses when going outdoors

  • following up with your doctors until your vision fully returns

These treatments can typically relieve symptoms in the early stages. However, surgery may be necessary if you have developed corneal ulcers.

You may also require additional treatment for any underlying health conditions contributing to vitamin A deficiency.

What is the outlook for people with xerophthalmia?

Without treatment, xerophthalmia can have serious implications. Researchers estimate that only 4 in 10 people with corneal xerophthalmia survive, and many survivors become partially blind.

If you have symptoms consistent with xerophthalmia, it is essential to contact your doctor right away. Prompt treatment can help prevent complications.

What are some potential complications of xerophthalmia?

Besides maintaining eye health and vision, vitamin A also supports your immune system and protects your vital organs. Vitamin A deficiency can lead to various complications, including:

  • dry, scaly, and itchy skin

  • delayed growth

  • night blindness

  • fertility problems

  • respiratory infections

  • anemia

  • death

Can you prevent xerophthalmia?

You can help prevent xerophthalmia by preventing vitamin A deficiency. Start by eating foods rich in vitamin A, such as:

  • fish

  • liver

  • sweet potatoes

  • carrots

  • spinach

  • fruits such as cantaloupe or mangoes

You may also wish to take vitamin A supplements. Be sure to consult your doctor before making these dietary changes.

Managing health conditions that contribute to nutritional deficiencies, such as celiac disease or chronic diarrhea, can help in preventing xerophthalmia.

Other frequently asked questions

Here are a few other commonly asked questions about xerophthalmia. Dr. Katherine Duncan has reviewed the answers.

Is xerophthalmia the same as night blindness?

Night blindness is a common symptom of xerophthalmia. Xerophthalmia results from a vitamin A deficiency, which can affect your ability to see in dim light.

Who is at risk for vitamin A deficiency?

According to experts, certain people may not be able to consume adequate amounts of vitamin A. In addition, some people cannot absorb the nutrient as needed. This can include people in developing countries, premature infants, or people with underlying conditions such as cystic fibrosis.


Xerophthalmia is an eye condition that results from vitamin A deficiency. Initial symptoms can include dry eyes, wrinkled eyeballs and eyelids, and night blindness.

To diagnose the condition, your clinician will ask questions related to your symptoms, medical history, and eating habits. They may also run tests to assess your eye health and check the levels of vitamin A in your body.

Treatments focus on increasing the levels of vitamin A in your body and managing your symptoms. This may involve vitamin A supplementation, preservative-free artificial tears, and antibiotics. You can reduce your risk of xerophthalmia by consuming more vitamin A-rich foods. You can also reduce your risk by managing underlying conditions that affect your body’s ability to absorb nutrients.

Schedule an appointment with your doctor if you have symptoms of xerophthalmia.



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