Related Experiment Videos
Corneal ulceration following measles in Nigerian children
Insights
Childhood blindness in Nigeria is often caused by corneal ulceration following measles in malnourished children. Vitamin A deficiency is not the primary cause, but protein-calorie malnutrition, measles keratitis, and herpes simplex are contributing factors.
Area of Science:
- Ophthalmology
- Pediatrics
- Nutrition
Background:
- Acute corneal ulceration is a leading cause of childhood blindness in Northern Nigeria, frequently following measles.
- Malnutrition significantly increases the risk of corneal ulceration in children, particularly after measles infection.
Purpose of the Study:
- To investigate the causes and contributing factors of acute corneal ulceration in malnourished children in Northern Nigeria.
- To assess the role of vitamin A deficiency, measles, and other factors in the development of corneal ulcers.
Main Methods:
- Conducted surveys in a school for blind children and among children with corneal scars.
- Analyzed clinical presentations of active corneal ulcers.
- Measured serum retinol-binding protein and prealbumin levels in affected children and a control group.
Main Results:
- 69% of blind children in a survey had corneal disease; 42% of corneal scars resulted from post-measles ulceration.
- Children with post-measles corneal ulcers had below-normal serum retinol-binding protein and prealbumin levels.
- Malnourished children without eye complaints after measles had even lower nutrient levels, suggesting vitamin A deficiency is not the primary cause.
Conclusions:
- Protein-calorie malnutrition, measles keratitis, and secondary herpes simplex infections are significant factors in post-measles corneal ulceration.
- While not the primary cause, vitamin A deficiency may be a contributory factor.
- Racial factors might also play a role in the incidence of corneal ulceration.
Abstract:
Acute corneal ulceration in malnourished children is the commonest cause of childhood blindness in Northern Nigeria and usually develops after measles. Other severe diseases in malnourished children rarely precipitate corneal ulceration. A survey in a school for blind children showed that 69% of the children were blind from corneal disease, and a survey of children with corneal scars showed that at least 42% were caused by ulceration after measles. The clinical appearance of the active ulcers was very varied. The serum retinol-binding protein and prealbumin levels in children with corneal ulcers following measles were below normal, but a group of malnourished children without eye complaints following measles were found to have even lower levels. Thus a specific deficiency of vitamin A does not appear to be the primary cause of these ulcers, though it may be a contributory one. A specific measles keratitis and secondary herpes simplex infectious may be local factors contributing to this ulceration, and there is nearly always a background of protein calorie malnutrition. Racial factors may also be of some significance.