Xerophthalmia (vitamin A deficiency with eye involvement)

Spectrum of eye involvement in severe vitamin A deficiency: night blindness (impaired rhodopsin synthesis), conjunctival and corneal xerosis, Bitot spots, keratomalacia and corneal scarring with irreversible blindness. The leading preventable cause of childhood blindness in developing countries. In Spain seen in patients with severe malabsorption (untreated coeliac, cystic fibrosis, Crohn, post-bariatric).

ICD-10 E50.71 drug

Also known as: Night blindness from vitamin A deficiency, Bitot spots, Keratomalacia

Drugs used for this condition

BBeta-caroteneAdd-on therapy · Provitamin A (plant precursor of retinol)Beta-carotene is a provitamin-A source, a supportive option for mild dietary vitamin A deficiency and for recovery after the acute phase, but not first-line for xerophthalmia. In Spain xerophthalmia occurs in patients with severe malabsorption; AEMPS registers Carotaben (50 mg capsules) mainly for erythropoietic protoporphyria, and it is used off-label in vitamin A deficiency. First-line for acute xerophthalmia is retinol, parenterally or orally (200 000 IU, WHO 2011), repeated at day 1 and week 2; beta-carotene is unsuitable for the acute stage due to slow conversion. Maintenance beta-carotene after the acute phase is 15–30 mg/day.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit