Conjunctival Xerosis
Hello everyone today let's discuss the causes and treatment of conjunctival xerosis.
So basically there are two types of conjunctival xerosis.
a. Epithelial xerosis
b. Parenchymatous xerosis
Epithelial xerosis.
The most common example is Xerophthalmia i.e. Vitamin A deficiency.
Let us discuss Xerophthalmia.
The cause of vitamin A deficiency is mostly its dietary deficiency or defective absorption.
The new WHO classification of Xerophthalmia
XN: Night Blindness
X1A: conjunctival xerosis
X1B: bitots spots
X2: corneal xerosis
X3A: keratomalacia <1/3rd of cornea
X3B: keratomalacia >1/3rd of cornea
XS: corneal scar
XF: fundal changes – known as Uyemura spots, these are defects in the Retinal
Pigment Epithelium.
Treatment:
It consists of local ocular therapy with artificial tears along with vitamin A therapy.
Schedule for vitamin A is as follows :
>1 year of age – 1lakh IU i.m. given on 0 1 14 days
OR
2lakh IU orally given on 0 1 14 days
<1 year of age – half the dose.
This has to be carried along with treatment of underlying causes like malnutrition or other disorders like diarrhoea dehydration.
Other causes of night blindness:
1. High myopia
2. Late stage of angle closure glaucoma
3. Oguchi syndrome
4. Gyrate atrophy of choroid
5. Retinitis pigmentosa
Parenchymatous Xerosis
It mainly involves the adenoid layer of the conjunctiva.
It can take place due two main reasons holla! We have a mnemonic here
1. Due to cicatrizing disorders (cicatrizing disorders turn conjunctiva reasonably shrivelled)
2. Due to over exposure to atmosphere ( marked exposure causes parenchymatous xerosis)
Cicatrizing disorders
1. Cicatricial phemphigoid
2. Diptheric membranous conjunctivitis
3. Trachoma
4. Chemical burns
5. Radiotherapy
6. Stevens-johnson syndrome
Overexposure to atmosphere
1. Marked proptosis
2. Ectropion
3. Coma (lack of blinking)
4. Palsy of cranial nerve 7 (facial palsy)
That’s all for now,
Stay Awesome!
Keep calm and keep studying!
- Ashish G. Gokhale
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