Nutritional ocular diseases and their association with diarrhoea in Matlab, Bangladesh

The prevalence of visual defects, especially from causes associated with nutritional deficiencies, and their relation to diarrhoea in rural Bangladesh have been studied. A trained physician and a team of health workers examined visual defects in 149 villages, with a total population of 182 976. According to WHO classification, night blindness (XN) was found in only 0.03 persons/1000 population and 0.04 were found to have conjunctival xerosis (XIA) and Bitot's spot (XIB). Corneal xerosis (X2, X3A, X3B) also was found in 0.04 persons/1000. Night blindness combined with conjunctival xerosis and Bitot's spot (XN + XIA + XIB) was present in 1.69 persons/1000 and all combined stages of active xerophthalmia were seen in 0.06 persons/1000. Xerophthalmia prevailed up to age 19 years. Males had a significantly higher (2.9) incidence/1000 than did females (1.2). The total rate of keratomalacial scar for all ages was 0.31 persons/1000, while corneal opacity from other causes was seen in 2.25 persons/1000 population. More than 2.06 persons/1000 had ocular manifestations of one or more vitamin A deficiencies, while 4.47 persons/1000 had other ocular diseases, except for cataracts. Only 12.0% of all the corneal scars (XS) were due to keratomalacia. History of night blindness is a good indicator of vitamin A deficiency. In 96% of cases, night blindness was associated with conjunctival xerosis and Bitot's spot (XN + XIA + XIB). The onset of approximately 86% of cases of corneal xerosis (X2, X3A, X3B) and night blindness associated with conjunctival xerosis and Bitot's spot (XN + XIA + XIB) was related to diarrhoea.