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A Treatment Package without Escape Extinction to Address Food Selectivity

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Xerophthalmia in Picky Eater Children.

Aiman Ifwat¹, On Heong Liew¹, Hanisah Abdul Hamid²

¹Department of Ophthalmology, Hospital Queen Elizabeth, Kota Kinabalu, MYS.

|April 11, 2022

Summary

Vitamin A deficiency (VAD) can cause severe eye problems like xerophthalmia, leading to blindness. Early detection and treatment are crucial, especially in children with dietary restrictions, to prevent irreversible vision loss.

Keywords:

bitot’s spots conjunctival xerosis corneal xerosis vad xerophthalmia

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Area of Science:

Ophthalmology
Nutritional Science
Pediatrics

Background:

Xerophthalmia, a spectrum of ocular manifestations of vitamin A deficiency (VAD), can progress to blindness.
Intellectual disabilities may present unique challenges in nutritional assessment and management.

Observation:

Two children with intellectual disabilities presented with severe xerophthalmia, including conjunctival and corneal xerosis and punctate keratopathy.
Both children had a history of highly restrictive diets, primarily consisting of rice and noodles.
Laboratory tests confirmed severe VAD with extremely low serum vitamin A levels (<0.10 µmol/L).

Findings:

The clinical presentation indicated advanced VAD, consistent with the observed ocular symptoms.
Dietary history was a key factor in identifying the cause of VAD.
Despite treatment, one child's condition deteriorated, leading to death from pneumonia, while the other showed improvement.

Implications:

Highlights the critical role of nutritional assessment in children with intellectual disabilities and selective eating habits.
Emphasizes the need for vigilant monitoring and prompt intervention for VAD to prevent severe ocular complications and mortality.
Underscores the importance of comprehensive dietary evaluation and supplementation in at-risk pediatric populations.