Abstract
Vitamin A deficiency and xerophthalmia are widely considered to be problems of developing countries. Indeed, more than 60 such countries are recognized by the World Health Organization as suffering from an aggregate 5 million new cases of xerophthalmia, one quarter million resulting in blindness, every year.1The true number may be twice as large: recent data suggest that a significant proportion of measles-associated blindness, the major cause of pediatric blindness in Africa, is secondary to acute decompensation of borderline vitamin A status.2The mechanism(s) by which vitamin A deficiency results in corneal ulceration and necrosis remains uncertain, but local sepsis appears to be a late and variable complication.3,4 See also pp 350 and 354. Recent data suggest that vitamin A deficiency also has a profound impact on general morbidity,5mortality,6-8growth,8,9and hematopoiesis.8,10Even subclinical deficiency may have important implications for survival.11