For maintenance of eye health, vitamin A is an important nutrient. Our body gets Vitamin A when we eat foods containing this vitamin. Lack of vitamin A causes eye diseases. It was found that vitamin A deficiency is the single greatest preventable cause of childhood blindness. People most at risk are children between six months to six years, pregnant women, and lactating women.

How is vitamin A important to the eye? Vitamin A maintains healthy cells in various structures of the eye and is required for converting light into nerve signals in the part of the eye called the retina. When vitamin A is not available to the body, gradual changes begin to affect the eye. The first sign of a problem is when a child or a pregnant or lactating woman finds it difficult to adjust to seeing in the dark. This condition is called night blindness.

Let us look at the case of four year old Nima from a village in Bangladesh. One bright summer afternoon, Nima and her older brother Karim were waiting for their hard-working parents to return from the fields. Nima was wearing an old but clean orange frock and was playing with her home-made dolls under the shade of the big tree.

Karim asked, "Hey, Nima, do you want to play 'hide and seek'? You can never catch me!"

Nima's face brightened with a lovely smile as she got up to take the challenge. She knew she could find Karim anywhere he hides. However, after three or four minutes when Nima couldn't find her tricky brother, she breezed into their dark and dungy store room at the back of the house. It was one of Karim's favorite hiding spots. Strangely, that day Nima could not see anything in the room. Then she heard a faint sound from a corner. Certain that it was Karim, she started walking fast towards the sound.

Then it happened. BOOM! CRASH! Nima found herself flat in the middle of a heap which felt like pieces of wood. Nima didn't know about the pile of firewood in the store room that her father kept before going to work that morning.

"OUCH! Karim, come! Where are you?", screamed Nima.

Karim came running and lifted his sister up, taking her to the main house. Luckily Nima only had a few scratches and bruises.

When their pregnant mother returned from the field, she allowed Nima to cuddle on her big tummy. Nima forgot about her pain and wanted to know when her little brother or sister would come out.

The next day, their friendly Lady Health Worker came to visit Nima's mother to check on her pregnancy. The Health worker noticed the scratches on Nima's forehead and asked, "What is the matter? Were you fighting with your brother?"

Nima's mother explained how she fell in the store room last evening. Nima's brother giggled and added mockingly, "She couldn't even see the pile of fire wood. Ha, ha!"

The health worker, who had been taking a course on eye diseases, looked at Nima's mother and wondered, "Did you notice if Nima has been finding it difficult to see when entering into a darker room from a brightly lit place?"

Nima's mother pondered for a minute and said, "Now that you ask, I think Nima has been falling down or bumping into things in the store room more often since she recovered from the measles recently."

The Health Worker looked concerned and said, "You should come to the clinic tomorrow because it is the day the doctor from the town visits our village. I think Nima is not able to adapt to seeing in the dark because she does not have enough vitamin A".

"What is vitamin A? What is going to happen to my Nima?" said the worried mother.

"Don't worry. It is good that I noticed the child at this time. It is not too late. Vitamin A is important for the eyes to work properly. So, when there is not enough vitamin A in the body over a period of time, the child gradually develops eye problems."

"What should I do now?" Nima's mother was almost in tears.

"Tomorrow, we will give vitamin A drops to Nima. It will correct the problem for now. We will also tell you about foods that you can give Nima and all of your other children to keep their eyes bright and healthy". With these words of hope, the Health Worker left.

The next day, Nima got vitamin A drops at the hospital. Her mother also learned about foods that contain vitamin A. After a few days, Nima felt well and was able to catch Karim without any problems, even when he was hiding in the dark store room!

Let us see what could have happened if Nima had not received timely help.

Vitamin A deficiency progresses slowly, causing more and more damage to the eye as the days go by. This condition is called Xerophthalmia, which is a range of disorders that affect the eye.

Symptoms:

Night blindness:

The child cannot see in the dim light or twilight. Nightblindness is also found in pregnant women in some instances, especially during the last trimester of pregnancy when the vitamin A needs are increased.

Bitot Spots:

These are foamy and whitish cheese-like tissue spots that develop around the eye ball, causing severe dryness in the eyes. These spots do not affect eye sight in the day light.

Blindness:

Once the dry eyes set in, the eye becomes very sensitive and begins to scratch and scar. The eyelids become swollen and sticky. This eventually leads to blindness. Once blindness occurs, it cannot be reversed.

Other symptoms of deficiency:

When the body lacks vitamin A, the systems that resist infection and disease do not work very well. That is why children with Vitamin A deficiency fall sick more often, take much longer to recover and are more likely to die. Problems with bones and teeth can also occur frequently.

Examples of what symptoms might look like

Therefore, it is important to recognize early symptoms and take action. The more important thing is to prevent this from happening in the first place. As with any other deficiency disorder, 'prevention is better than cure'. Understanding the deficiency and the body's need for vitamin A will help.

Ways to Prevent Vitamin A Deficiency:

To successfully reduce vitamin A deficiency, short-term and long-term measures should be taken. The main goal is to ensure adequate intake of vitamin A, which prevents vitamin A deficiency.

The different approaches include:

Breastfeeding

Vitamin A supplementation

Food fortification

Promotion of vitamin A-rich diets

Now let us look at these approaches in some detail:

Breast feeding:

The basis for lifelong health begins in childhood. Breast milk is a natural source of vitamin A. The best way for the baby to get vitamin A is through the mother's milk. Promoting breast feeding is like planting early seeds of protection.

Vitamin A supplementation:

Vitamin A supplementation involves the twice-yearly intake of high doses of Vitamin A drops or syrup in children between 6 months and 6 years. Soon after childbirth, mothers are also given vitamin A supplements. Programs to administer vitamin A are widely implemented by many countries. Several countries provide vitamin A supplementation during polio camps, measles vaccinations, and national immunization days. It is important for families to take their children to these camps to receive the vitamin A. If camps are not organized, they can ask for information at their nearest health center.

Food fortification:

In some countries, Vitamin A is added to foods like oil, sugar, milk and flour. This helps to provide vitamin A when the regular diet does not contain the vitamin in sufficient amounts.

Promotion of vitamin A-rich diets:

For long term impact, it is always good to know the natural sources of vitamin A and eat these foods whenever possible.

Food Sources of Vitamin A

Sources of vitamin A can be divided into two groups: one is animal source, and the other is vegetable source. Vitamin A is better absorbed from an animal source, but when it is not always possible to afford animal foods, vitamin A derived from vegetables sources are also important.

Examples of animal food sources are as follows:

Liver

Fish liver oil

Egg yolk

Milk and milk products

Breast milk

Butter

Small fish

Examples for vegetable sources are as follows:

Dark green leaves

Yellow and orange vegetables (like carrot, sweet potatoes, yellow yam)

Yellow and orange fruits (like papaya, mangoes)

Red palm oil

What can you share with family and friends?

Vitamin A is important for the health and well being of the eye and other body functions

The human body needs 500-600 milligrams of vitamin A per day

To increase the body's intake of vitamin A, cook foods with fat or oil

Vitamin A is found in animal foods as well as vegetable foods

Grow fruits and vegetables in home gardens

Make sure all your children between 6 months and 6 years get vitamin A supplementation two times in a year. Ask your nearest health center where and when to get the vitamin A supplements.

If you come across early symptoms of vitamin A deficiency like nightblindness, seek immediate help

Did you know?

For thousands of years, liver has been used as a cure for night blindness, but it was only in the early 20th century that liver was discovered to be rich in vitamin A, which is essential for healthy eyes.

Vitamin A deficiency causes 350,000 children to go blind each year. About 140 million children in 118 countries are Vitamin A deficient. 1 in 4 child deaths are caused by Vitamin A deficiency. 30% of the world's blindness is due to vitamin A deficiency. 600,000 women die during child birth due to complications from vitamin A deficiency.

Quiz

The symptoms of vitamin A deficiency include all of the following EXCEPT

Select an answer A. night blindnessB. bitot spotsC. dental problemsD. increased thirst

Bitot spots occur on which part of the eye?

Select an answer A. corneaB. lensC. retinaD. macula

How often should vitamin A supplementation be taken?

Select an answer A. two times per yearB. four times per yearC. one time per yearD. twelve times per year

Which of the following is NOT a food source of vitamin A?

Select an answer A. milk and milk productsB. fish liver oilC. egg yolkD. rice