From the Guidelines
Vitamin A deficiency primarily manifests as night blindness, dry eyes (xerophthalmia), Bitot's spots (foamy patches on the eye), corneal ulceration, and in severe cases, blindness, and its treatment involves immediate vitamin A supplementation, typically administered as retinol palmitate, with dosages dependent on the severity of the deficiency and the patient's age, as recommended by the most recent guidelines 1. The symptoms of vitamin A deficiency can be categorized into:
- Ocular symptoms: night blindness, dry eyes (xerophthalmia), Bitot's spots (foamy patches on the eye), corneal ulceration, and in severe cases, blindness
- Systemic symptoms: dry skin, frequent infections, poor wound healing, and growth retardation in children
- Increased susceptibility to infections, especially of the respiratory tract, due to impairment of the intestinal immune and barrier function 1 The treatment of vitamin A deficiency involves:
- Immediate vitamin A supplementation, typically administered as retinol palmitate
- Dosages dependent on the severity of the deficiency and the patient's age, with the WHO recommending 200,000 IU orally on day 1, followed by another 200,000 IU the next day, and a third dose 4 weeks later for severe deficiency in children 1
- For adults, a single dose of 200,000 IU followed by daily supplements of 10,000-20,000 IU for 2 weeks, then 10,000 IU daily for 2 months is effective, while pregnant women should receive lower doses (up to 10,000 IU daily) to avoid potential birth defects 1 Long-term prevention involves dietary changes to include vitamin A-rich foods such as liver, eggs, dairy products, orange and yellow fruits, and dark green leafy vegetables, and monitoring of vitamin A levels, especially in high-risk populations such as patients with liver disease, chronic kidney disease, and those undergoing bariatric surgery 1.
From the Research
Vitamin A Deficiency Symptoms
- Night blindness, which is the inability to see in low light [(2,3,4)]
- Xerophthalmia, a condition characterized by dryness of the conjunctiva and cornea [(2,3,4)]
- Corneal xerosis, which can lead to corneal ulceration and liquefactive necrosis (keratomalacia) [(2,5,3)]
- Bitot spots, which are small, foamy patches on the conjunctiva [(2,5,3)]
- Conjunctival xerosis, which is a dryness of the conjunctiva 2
- Impaired growth and development [(6,4)]
- Increased susceptibility to infections [(2,3,4)]
Treatment of Vitamin A Deficiency
- Administration of high-dose vitamin A supplements (200,000 IU orally, repeated after 24 hours) 2
- Food fortification with vitamin A [(6,2)]
- Diet diversification to include vitamin A-rich foods [(6,2)]
- In cases of corneal xerophthalmia, treatment as a medical emergency is necessary 2
- Interdisciplinary cooperation is essential for the diagnosis and treatment of vitamin A deficiency 5