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Key Features

  • One of the most common vitamin deficiency syndromes in developing countries

  • Most common cause of blindness in developing countries

  • In the United States, occurs most commonly in the elderly and urban poor or from fat malabsorption syndromes or mineral oil laxative abuse

Clinical Findings

  • Night blindness (early)

  • Dryness (xerosis) of conjunctivae and small white patches on the conjunctivae (Bitot spots) (early)

  • Ulceration and necrosis of the cornea (keratomalacia), perforation, endophthalmitis, and blindness (late)

  • Xerosis and hyperkeratinization of the skin

  • Loss of taste

Diagnosis

  • Abnormalities of dark adaptation

  • Serum vitamin A levels below normal range of 30–65 mg/dL

Treatment

  • Early deficiency: vitamin A 30,000 international units orally once daily for 1 week

  • Advanced deficiency: vitamin A 20,000 international units/kg orally once daily for at least 5 days

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