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Sociodemographic features and risk factor profile of keratomalacia in early infancy
1Cornea & Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
Insights
Inadequate breastfeeding causes keratomalacia in infants under 6 months. Poor maternal nutrition, low socioeconomic status, and lack of feeding knowledge are key risk factors.
Area of Science:
- Ophthalmology
- Pediatrics
- Public Health
Background:
- Keratomalacia is a severe form of vitamin A deficiency.
- Early infancy is a critical period for nutritional status and eye health.
Purpose of the Study:
- To investigate the clinical features and causes of keratomalacia in infants under six months.
- To identify risk factors contributing to this condition in early infancy.
Main Methods:
- Retrospective review of 33 infant case records (under 6 months) with keratomalacia.
- Evaluation of nutritional status, socioeconomic factors, maternal health, and feeding practices.
- Comprehensive ophthalmic examinations were performed.
Main Results:
- Protein energy malnutrition was present in 88% of infants.
- Inadequate breastfeeding was the primary cause in all cases.
- Poor maternal nutrition (82%) and lack of knowledge were significant contributing factors.
Conclusions:
- Inadequate breastfeeding is the main cause of keratomalacia in early infancy.
- Lower socioeconomic status, poor maternal nutrition, and insufficient knowledge of feeding guidelines are critical risk factors.
- Addressing these factors is crucial for preventing infant keratomalacia.
Purpose:
To study the clinical spectrum and etiopathogenesis of keratomalacia in infants younger than 6 months.
Methods:
Case records of children younger than 6 months presenting with keratomalacia to cornea services of a tertiary care ophthalmic center in India from June 2007 through April 2010 were reviewed. The parameters evaluated were age, sex, anthropometry, nutritional status, socioeconomic status, antenatal history, maternal nutrition, systemic associations, immunization, and dietary history. Comprehensive ocular examination with emphasis on ocular adnexa, conjunctiva, cornea, and anterior chamber was performed.
Results:
Overall, 33 infants (24 male and 9 female) with mean age of 2.8 ± 1.3 months (range = 1-6 months) were included. Eighty-eight percent (29 of 33) had associated protein energy malnutrition. A total of 31 of 33 children (94%) belonged to poor families, and nearly, three fourth of the children were not fully immunized as recommended for their age. Inadequate breastfeeding was the precipitating cause in 100%. Maternal nutritional status was poor in 82% of the cases. The reason for not breastfeeding the infant was inadequate milk production in 89.4% of mothers, 64.7% were ill informed, and 1 mother had adopted a child. Feeding practices included diluted cow's milk (1:1-1:5) in 21 infants (63.6%), toned dairy milk in 9 infants (27.3%), infant lactogen in 2 infants (6.1%), and skimmed milk powder in 1 infant (3.0%).
Conclusion:
Keratomalacia in early infancy can be attributed to inadequate breastfeeding. Important contributory risk factors include lower socioeconomic status, poor maternal nutrition, and lack of knowledge about recommended feeding guidelines.
