What Is Keratomalacia?

Keratomalacia is a progressive, bilateral eye disease that, if left untreated, can lead to blindness in both eyes. This disease is characterized by degeneration of the cornea and lacrimal glands. The cause of keratomalacia is vitamin A deficiency. Treatment of the condition typically involves aggressive vitamin A replacement, topical antibiotics to prevent infections in the fragile cornea, and use of lubricating eye drops to combat dry eyes. Keratomalacia is also sometimes referred to as xerophthalmia or xerotic keratitis.

This eye disease usually begins with the clouding and relaxing of the typically rigid cornea which causes difficulty seeing at night, also known as night blindness. The cornea is the clear, superficial covering on the eye that works with the lens to focus light onto the retina. Changes in the cornea weaken it and make it susceptible to infection and further damage. Eventually, the function of the lacrimal glands, or tear-producing glands, located in the corners of the eye are impaired, resulting in dry eye. Dry eye can lead to the development of Bitot’s spots, or protein deposits which form in the delicate membrane covering the sclera, or the white part of the eye, further impairing vision.

Cornea damage due to keratomalacia cannot be reversed. The only hope of treating this disease is to catch it early enough to prevent further damage and complete vision loss. Immediate treatment is to augment the diet with vitamin A, beta carotene and retinoids. This treatment will gradually arrest the cornea and lacrimal gland damage.

In addition, eyes damaged by keratomalacia are typically treated with topical antibiotics to prevent or stem the infections common in the damaged cornea. If damage to the lacrimal glands is advanced enough to cause dry eye and Bitot’s spots, the eyes will also be treated with lubricating drops to replace the decreased or arrested tear production. When damage to the lacrimal glands is advanced, it may be necessary to keep the patient in a highly humidified environment to prevent extreme drying of the eyes.

Vitamin A deficiency may have many causes. This vitamin insufficiency can be the result of starvation or malnutrition when food supplies or diverse and nutritious food supplies are limited. Deficiency of vitamin A can also be caused by not eating foods rich in beta carotene, such as green leafy vegetation or orange-colored vegetables and fruits and foods rich in retinoids such as liver and eggs. Beta carotene and retinoids are turned into vitamin A in the body. Vitamin A deficiency can also be caused when the body is unable to absorb beta carotene or retinoids or is unable to convert beta carotene or retinoids to vitamin A.