Indian Journal of Ophthalmology

: 1983  |  Volume : 31  |  Issue : 4  |  Page : 379--381

Clinico biochemical study of xerophthalmia in rural population of Allahabad

D Srivastava, RN Misra, SK Satsangi, Kamaljeet Singh, VP Sardana 
 Institute of Ophthalmology, Allahabad, India

Correspondence Address:
D Srivastava
State Institute of Ophthalmology, Allahabad

How to cite this article:
Srivastava D, Misra R N, Satsangi S K, Singh K, Sardana V P. Clinico biochemical study of xerophthalmia in rural population of Allahabad.Indian J Ophthalmol 1983;31:379-381

How to cite this URL:
Srivastava D, Misra R N, Satsangi S K, Singh K, Sardana V P. Clinico biochemical study of xerophthalmia in rural population of Allahabad. Indian J Ophthalmol [serial online] 1983 [cited 2020 Aug 10 ];31:379-381
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Full Text

Xerophthalmia is a world wide problem and high prevalence has been reported from developing countries. It remains an impor­tant cause of childhood blindness accounting for 200.00 to 100,000 new cases annually.

A classification of xerophthalmia [Table 1] was proposed in 1976 by W.H.O. follows :


1. XIB in more than 2.0 %, of the popu­lation at risk

2. X2+X3A-+-X3B in more than 0.01 °, of the population at risk

3. XS (attributable to vitamin A deficiency) in more than 0.1 % of the population at risk


4. Plasma vitamin A level of less than 10 micro gram/ 100 ml. in more than 5.0% of the population at risk.

The population at risk is below 6 years of age.

Very few surveys have been done in North India. No survey has been done in the rural population of Allahabad. In the present study a survey of rural population was done according to standards laid down by W.H.O.


Between January 1982 to September 1982 the rural children of less than 6 years of age were examined in Sarangapur Balapur and Rampur. 1025 children were examined with the help of hand light and loupe and lens. Fundus examination was done in cooperative patients and vision was estimated according to W.H.O standards. All children were classified according to standard classification.

Serum vitamin A estimation was done by flurometric technique and serum protein was estimated by colorometrie method.


The study was conducted on total 1025 children between the group 0 to 6 years (shown in [Table 2]).

Out of studied 1025 children [Table 4] the xerophthalmic was seen in 196 children of various age groups. Minimum number of xerophthalmia cases were seen in age group 0 to I years. Maximum number were seen in the age group 5 to 6.

Serum vitamin A was studied in 90 cases of different stages of xerophthalmia [Table 5]. In 60 cases the serum vitamin A level was in between 10 to 20 micro gram %. While in 28 cases it was normal i.e. more than 20 micro gram %. In 2 cases of keratomalacia it was less than 10 micro gram%.

Serum protein was normal in all the cases of XIB. However, in 2 cases of kerato­malacia (X3B) it was much below the normal levels i.e. 2.8 gm% & 3.2 gm%.


Conjunctival xerosis was observed in 10.8% of the cases. This lower rate of prevalence in our study may be due to exclusion of cases of conjunctival xerosis with Bitot's spot.

XIB has been observed in 7.8% cases [Table 6] which is much more than the criteria fixed by W.H.O. (2%) for deciding rerophthalmia as significant health problem.

X2, X3A, X3B was seen in 0.19% cases which is also higher the criterion of 0.01 % [Table 6].

XS was present in 0.48% cases being much higher than the criterion of 0.1% [Table 6].

Thus, it is clearly indicated that these data are showing much more prevalence than the criteria laid to decide whether a significant public health problem of xerophthalmia exists.

Serum vitamin A [Table 5] was low in 37.5% cases of XIA which suggests that the XIA may not be excluded as a sign of vitamin A deficiency as advised by WHO. It was seen to be low in 88.4% cases of XIB which is in accordance with the study of Sommer et al (1980).

Serum protein was found to be low only in cases of keratomalacia.


1023 cases below 6 years of age were examined in villages of Allahabad. Serum vitamin A and serum protein estimation was done in cooperative patients. It has been concluded in this study that according the criteria laid down by WHO (1976) significant public health problem of xerophthalmia exists in Allahabad and conjunctival xerosis (XIA) should not be excluded as a sign for vitamin A deficiency in this age group as suggested by WHO.