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What Is Keratomalacia?

Medically Reviewed by Dan Brennan, MD on May 13, 2021

Keratomalacia is a health condition affecting your eyes that is caused by a lack of vitamin A in your diet. This condition leads to the cornea getting cloudy and soft. The health condition is preceded by severe dry eye, also called xerophthalmia.

Impact of Keratomalacia on Your Health

Keratomalacia is also called xerotic keratitis or corneal melting. Your eye has a thin mucus membrane called the conjunctiva. It is on the inside of your eyelid and over the front of your eye. The membrane serves to protect your eye from bacteria and debris. Over time it may become dry, thick, wrinkly, and cloudy.

Your cornea is the clear layer of your eye. It is behind the conjunctiva, so when the conjunctiva weakens, your cornea softens. This may lead to:

  • Infection
  • Changes to your eye structure
  • Changes to your vision‌
  • Blindness

If you don’t get enough vitamin A in your diet, you’re susceptible to developing keratomalacia. It usually affects both eyes, and the deficiency must be severe to cause this health condition. If you eat foods rich in vitamin A, but your body still develops this condition, you may have an inability to metabolize it.

Understanding xerophthalmia. If you have dry eyes, talk to your doctor right away. While occasional dryness isn’t concerning, if your eyes are persistently dry, it’s a sign of an eye condition called xerophthalmia.

If your dry eye persists without treatment, it may progress into keratomalacia. While some damage is reversible, eventually, your eye damage may require surgery.

Keratomalacia symptoms. Talk to your doctor about changes in your vision or how your eyes feel. Signs of keratomalacia include:

  • Difficulty seeing clearly at night or in dim light
  • Severe dryness
  • Cloudiness in your vision
  • Debris build-up‌
  • Spots in your vision that are gray, patchy, or foamy

Your doctor can complete lab tests to determine if a vitamin A deficiency is to blame. If your body cannot metabolize nutrients effectively, there may be an underlying reason that needs to be addressed.

Diagnosing keratomalacia. Your doctor may refer you to an optometrist who specializes in the care of eyes. A visual exam determines the signs of keratomalacia, and blood work shows if you have a vitamin deficiency. If your optometrist is still unsure of your diagnosis, they may perform an electroretinography. This tests the cells in your eyes that are sensitive to light.

Treating Keratomalacia. For treatment, you need to get more vitamin A in your diet to prevent further damage to your eyes. Your doctor may give you antibiotic eye drops or ointment to help heal the condition.

If you go without treatment for too long, you may need surgery to repair the damage. A keratoplasty surgery transplants your corneas to improve your vision.

You’re at a greater risk for developing keratomalacia if you:

  • Are an infant or young child
  • Live in poverty and have limited or no access to healthy foods and health services
  • Are malnourished
  • Live in a developing country
  • Have high alcohol consumption‌
  • Have a health condition like IBD, liver disease, or cystic fibrosis

How to Prevent Keratomalacia From Affecting Your Health

Vitamin A is also called retinol or retinoic acid. It has antioxidant properties that help protect your body against free radicals. It also supports:

  • Vision
  • Growth
  • Division of cells
  • Reproduction‌
  • Immunity

Foods rich in vitamin A include:

  • Leafy greens like spinach
  • Dairy
  • Liver
  • Carrots‌
  • Cantaloupe

If you don’t eat enough of these foods, you may consider taking a multivitamin or vitamin A supplement. The vitamin A recommendation for men is 900 micrograms each day and 700 micrograms for women.

Risks of Keratomalacia

Surgery. If you need surgery to address damage from keratomalacia, you’re placed on a transplant list. When an organ donor passes away, you may be eligible to receive their corneas to replace your damaged ones.

You may need to meet eligibility guidelines for the surgery. The good news is, tissue matching isn’t usually necessary because corneas are rarely rejected following surgery.

Blindness. Blindness occurs when light no longer reaches your retina. If keratomalacia is left untreated, you may sustain permanent damage. Even if you aren’t completely blind, you may lose part of your vision that doesn’t improve with the use of glasses or contacts.

Show Sources

SOURCES:

Cleveland Clinic: “Why Are My Eyes So Dry? An Ophthalmologist Explains Dry Eyes and Treatments.”

Mayo Clinic: “Vitamin A.”

Merck Manual: “Blindness,” “Corneal Transplantation,” “Keratomalacia.”

National Organization for Rare Disorders: “Keratomalacia.”

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