Corneal Stigmata of Acute Malnutrition: A Case Series

Childhood malnutrition is one of the leading causes of under-five mortality due to increased susceptibility of infections and slow recovery from illness, making it a major public health problem. Ocular involvement in malnutrition is common and more severe in early childhood. Acute malnutrition is an important cause of preventable blindness. Deficiencies of micronutrients and retinol, folate and minerals like iron, magnesium and potassium as well as other vitamins are usually seen in acute malnutrition. Vitamin A deficiency is particularly important, as it can lead to keratomalacia and permanent blindness. The present case series of children (under-five years) elaborates on the ocular consequences of acute malnutrition like conjunctival xerosis, corneal ulceration, keratomalacia, corneal abscess, corneal perforation, desmetocele, corneal scarring and xerophthalmia associated with vitamin A deficiency and their management. It emphasises the importance of preventing xerophthalmia to reduce early childhood blindness. Active corneal xerophthalmia is a medical emergency that should be treated immediately with high dosage of vitamin A. The highdose vitamin A treatment is recommended for infants and young children with xerophthalmia, severe malnutrition, and measles. Prompt diagnosis and timely intervention are required to prevent the ocular morbidities associated with vitamin A deficiency and acute malnutrition. Vitamin A supplementation programs should be made universally available in all populations where vitamin A deficiency is a public health problem.