Corneal xerophthalmia and keratomalacia
A. Sommer and T. Sugana
Detailed examinations were conducted on 162 consecutive children with
nutritional keratopathy. Surface changes ranged from mild haziness through
generalized xerosis and formation of thickened keratinized plaques. Diffuse
stromal edema occured early in the disease. Stromal loss took two forms:
relatively small, sharply demarcated, eccentric, noninfiltrated cylindrical
ulcers of varying depth; and localized or generalized, usually
full-thickness necrosis. All forms of involvement were sometimes present in
the same individual or even the same eye. Traumatic separation of a
keratinized plaque, or decompensation of a dellen, accounted for some
instances of stromal baring. In other cases, stromal melting appeared to
progress below an intact epithelium. Focal areas of necrosis healed
rapidly, as adherent leukomas; larger lesions sloughed, forming extensive
descemetoceles. With therapy, the vast majority of children retained
central corneal clarity.
