keratomalacia /-məlā″shə/ [Gk, keras + malakia, softness] , a condition characterized by xerosis and ulceration of the cornea, resulting from severe vitamin A deficiency. It commonly occurs as a secondary result of diseases that affect vitamin A absorption or storage, such as ulcerative colitis, celiac syndrome, cystic fibrosis, and sprue. Also at risk are infants and children who are given dilute formula, who are malnourished, or who are allergic to whole milk and fed skimmed milk, which is a poor source of vitamin A. See also vitamin A. ▪ OBSERVATIONS: Early symptoms include night blindness; photophobia; swelling and redness of the eyelids; and drying, roughness, pain, and wrinkling of the conjunctiva. ▪ INTERVENTIONS: Treatment consists of vitamin A supplements. The dosage is determined by the severity of the condition, although prolonged daily administration of large doses, especially to infants, may result in hypervitaminosis. An adequate diet containing whole milk and foods high in vitamin A or carotenes prevents the condition. ▪ PATIENT CARE CONSIDERATIONS: In advanced deficiency, Bitot’s spots appear; the cornea becomes dull, lusterless, and hazy, and without adequate therapy it eventually softens and perforates, resulting in blindness.
