Kajal eye staining for early detection of vitamin A deficiency in the field

Staining of the eyes with carbon black ("kajal") was tried out in 500 children, age 1--15 years, partly urban and partly rural, in Jaisalmer District. Of the eyes of 280 rural boys 21.4% took the stain, of 50 girls 16.0%. In the urban groups the figures were 5.7% of 88 and 9.7% of 82, respectively. These figures conincided nearly wholly with the cases diagnosed X1A (conjunctival xerosis) or X1B (conjunctival xerosis with Bitot's spots) clinically. All Bitot's spots were stained black; in addition also 2.6% of cases diagnosed X1A. Eight cases presenting only nightblindness also stained. Since kajal application is harmless, cheap, and acceptable to Indian custom it is proposed as a diagnostic procedure suitable for the general duty doctor and paramedical staff in the field.