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DESCRIPTION
Bitot's spots are distinct elevated white patches on the conjunctiva, the membrane that covers most of the visible part of the eye. They may signify a severe deficiency of vitamin A.
Xerophthalmia is a major cause of blindness in children in Africa and Latin America.
- Peak incidence is 3-5 years of age.
- Associated with vitamin A deficiency and malnutrition in general.
Clinical Features:
- Night blindness is an early manifestation. Later, there is drying - xerosis - of the conjunctiva with the development of characteristic oval or triangular spots - Bitot's spots.
- Xerosis of the cornea is seen initially as a mild haziness inferiorly. This is followed by corneal ulceration with full thickness dissolution known as keratomalacia - there may be extrusion of the intraocular contents.
Courtesy of www.opt.indiana.edu
SIGNS OF VITAMIN A DEFICIENCY
Vitamin A deficiency results in atrophy and keratinisation of epithelium, leading to:
- Dry skin and hair.
- Increased incidence of ear, sinus, respiratory, urinary, and digestive infection.
- Inability to gain weight.
- Drying of the cornea with ulceration - xerophthalmia.
- Nervous disorders.
- Skin sores.
- There may be night blindness or decreased ability for dark adaptation.
VITAMIN A & PREGNANCY
There is concern that excessive quantities of vitamin A may have a teratogenic effect. Two metabolites (trans-retinoic acid - RA, tretinoin, and 13-cis retinoic acid - CRA, isotretinoin) are believed to be responsible for this.
There are no convincing cases of a fetus being deformed as a result of excessive vitamin A intake from food, however, pregnant women have been warned against eating liver.
Women can be assured that eating a balanced diet which does not include liver will provide an adequate vitamin A intake. See MoonDragon's Nutritional Pages for more information about pregnancy and nutrition.
There is no reason to change the normal provision of vitamin A supplementation during pregnancy, under the supervision of a health care provider or a midwife, provided women are advised of the importance of keeping to the recommended dose.
There have been reports of undesirable side-effects following massive doses of vitamin A supplements in infancy.
TREATMENT
Topical antibiotics are given to prevent secondary bacterial infection. Keratomalacia is irreversible and causes permanent corneal scarring.
HOLISTIC RECOMMENDATIONS & NUTRITION
Vitamin A therapy and a protein-rich diet are essential.
Dietary supplements rich in vitamin A or beta-carotene should be provided in high risk areas to prevent the condition. High doses of vitamin A should be avoided during pregnancy because the risk of vitamin A embryopathy.
RECOMMENDATIONS
Increase your intake of vitamin A. See Vitamin A and the Carotenoids for more information about this vitamin supplement.
Avoid eyestrain and smoke-filled rooms.
Drink fresh carrot juice. This can help to prevent or alleviate some eye problems. Taking two tablespoons of cod liver oil daily can also be helpful. Both are rich in vitamin A.
MoonDragon's Nutrition Therapy: Juicing
NUTRITIONAL SUPPLEMENTS
Nutritional supplementation is important for people with Bitot's spots and xerophthalmia. Unless otherwise specified, the dosages recommended here are for adults. For a child between the ages of 12 and 17, reduce the dose to 3/4 the recommended amount. For a child between 6 and 12 years of age, use 1/2 the recommended dosage, and for a child under the age of 6, use 1/4 the recommended amount.
NUTRIENTS Supplement Suggested Dosage Comments Vitamin A
Plus
Carotenoid Complex
With
Lutein
And
ZeaxanthinTherapeutic Beta Carotene Doses: 100,000 IU daily for 2 weeks, then 50,000 IU daily for 1 month, then reduce to 25,000 IU daily.
For Vitamin A Doses: 25,000 IU for 2 weeks, then 15,000 daily for 1 month, the reduce to 10,000 IU daily.
If you are pregnant, do not exceed 10,000 IU daily.
For Carotene Complex: As directed on label.Aids in dissolution of Bitot's spots, which may be caused by a vitamin A deficiency. Use emulsion form for easier assimilation and greater safety at higher doses.
Vitamin A, 10,000 IU, 100% Natural, Nature's Way, 100 Softgels,
Beta Carotene (Natural Dunaliella Salina), Nature's Way, 100% Natural, 25,000 IU, 100 Softgels,
Multi-Carotene Antioxidant, Nature's Way, 60 Softgels
TYPES OF EYE PROBLEMS & DISORDERS
Maintaining Healthy Eyes
NOTIFY YOUR MIDWIFE OR HEALTH CARE PROVIDER IF...
You or a family member are having problems with vision and/or you suspect a vitamin A deficiency.
You have any increase of symptoms.
You have any unexpected or unusual symptoms. There may be underlying health issues that need to be addressed. Vitamin A toxicity is a potential problem when using high doses of vitamin A. If you are pregnant, do not exceed recommended dosages.
You should have your eyesight checked regularly by your health care provider to rule out any problems and to receive a prescription for contacts or eyeglasses, if they are needed. Preserve you vision... it is very important.
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