Stage Feature Earliest symptom Q X N Night blindness Q X 1 A Conjunctival xerosis Patches of dry, lusterless, nonwettable conjunctiva described as emerging like sand banks at receding tide X 1 B Bitots spot Q Usually B/L temporal raised, silvery white foamy triangular patch of keratinized epithelium situated on bulbar conjunctiva X 2 Corneal xerosis Punctate keratopathy f/b dry, hazy & lustureless cornea X 3 A Corneal ulceration / keratomalacia affecting < 1/3 corneal surface X 3 B Corneal ulceration / keratomalacia affecting > 1/3 corneal surface X S Corneal scar X F Xeropthalmic fundus Management of Xeropthalmia Prophylaxis (Vitamin A) Treatment 11111 Infant 6-12 1 lac IU orally * Local ocular therapy e.g. months old every 3-6 aificial tears etc. or any children < months * Vitamin A therapy 20,000 IU orally or 10,000 IU 8 kg All patients of > 1 year age except women 1-6 year children 2 lac IU orally every 6 months of reproductive IM on 1st day 2nd day Lactating 20,000 IU mother orally once at delivery or age & 4 weeks later during the Children < 1 Half of the next two months to year age or < 8 kg weight above dose protect breastfed Women of reproductive pregnant or not: age infant Upto X 1B 10,000 IU Infants < 6 months not being 50,000 IU orally stage orally daily for 2 weeks breastfed - Corneal xerospthalmia Dose of > 1 year age (2, 3A, 3B)">