Author: Kazi Shabbir Anwar (1) ([email protected]) and Sarwar Alam (2)
(1)Bangladesh Eye Hospital, House 19/1, Road 6, Dhanmondi, Dhaka, Bangladesh and
(2)Islamia Eye Hospital, Dhaka, Bangladesh
An estimated 42,000 children are blind in Bangladesh, and 32% of them are blind from preventable causes, such as vitamin A deficiency mostly following diarrhoea and measles.
A prospective study was conducted in a tertiary-level eye hospital to document the role of diarrhoea in developing childhood blindness due to vitamin A deficiency and infection.
The study was conducted at the Departments of Pediatrics and Cornea of a tertiary eye hospital between June 2002 and May 2003. All patients aged 1-10 year(s) who presented with a recent (less than one month) bilateral central corneal opacity and a definite history of diarrhoea in the preceding month were included in the study. The trained paediatric and cornea specialists examined each patient. B-scan (ocular ultrasonogram) was done in all patients to evaluate the status of posterior segment to exclude cataract, vitrous opacity, retinal detachment, etc.
In total, 36 children, including 21 females and 15 males, were enrolled in the study. Following treatment in the hospital, 29 patients still had severely low vision due to bilateral thick central corneal opacity. Two patients improved significantly with appropriate treatment with vision better than 6/12, while 3 ended up with 6/18, and 2 others with 6/60. Eight of these children had cataract (3 bilateral). The history-taking revealed that 8 of the 36 patients received vitamin A capsules within 6 months of the diarrhoeal episode, while 3 had received vitamin A during or after the occurrence of diarrhoea. None had any eye examination before presenting to this study group, and none had received any
medication for eye. The parents of these children knew how to rehydrate a diarrhoea patient but none of them was aware of the importance of eye care during and immediately after a diarrhoeal episode.
There is a lack of awareness among primary care physicians and attendants of children suffering from diarrhoea regarding the importance of adequate eye care to prevent serious ocular complications like blindness. Proper treatment and preventive measures can minimize the occurrence of ocular complications in children with diarrhoea.
Acknowledgements: The support of Dr. Niaz Rahman of Bangladesh Eye Hospital who helped with B-scan of the study patients is acknowledged.