Medical Evaluation of Nutritional Status: IV. The Ocular Manifestations of Avitaminosis a, with Especial Consideration of the Detection of Early Changes by Biomicroscopy

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Abstract
Of 143 persons in a low-income group, 45% had gross and another 54% had microscopic ocular lesions characteristic of avitaminosis A. The ocular condition was xerosis con-junctivae. Following adm. of vit. A as specific therapy to a part of the group, the conjunctival lesions in 9 persons disappeared, as judged in all instances by biomicroscopic examination. In all others receiving therapy, the conjunctival lesions have receded almost to the point of disappearance. In all cases the striking feature is the long time required for complete recovery, a matter of mos. even with therapy of high potency. Persons not receiving therapy have shown no improvement. Xerosis probably precedes night blindness as an early sign of avitaminosis A. For detection of early avitaminosis A in surveys, the biomicroscopic examination is recommended as a simple, convenient, objective method. When it is combined with gross examination, all degrees of xerosis may be graded according to severity and extent. The marked prevalence of avitaminosis A in this low income group, objectifying and validating previous dietary data, suggests its relatively frequent occurrence in the population at large.

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