1. VITAMIN A

2. β carotene
All-trans retinol
retinal
All-trans retinal
retinol
Visual cycle
retinyl
esters
Retinoic acid
retinyl palmitate
Nuclear receptor

3. SOURCES

4. LIFE STAGE DAILY REQUIRMENT ( μg/day)
Infants
0-6 months 400
7-12 months 500
Children
1-3yr 300
4-8yr 400
Males
9-13yr 600
>13yr 900
Females
9-13yr 600
>13yr 700
Pregnancy 750
Lactation 1200

5. Vitamin A deficiency
WHO CLASSIFICATION OF XEROPTHALMIA
XN Night blindness (nyctalopia)
X1A Conjunctival Xerosis
X1B Bitot’s spots
X2 Corneal Xerosis
X3A Corneal ulceration (<1/3rd)
X3B Corneal ulceration(>1/3rd )
XS Corneal scar
XF Xeropthalmic fundi

6. Bitot spots

7. Keratomalacia

8. Other manifestations
Skin and Epithelial cells:
Phrynoderma/toad skin
Keratinization of GI,respiratory and urogenital tracts
Reproductive system:
Degeneration of germinal epithelium- infertility
Growth retardation

9. Hyperkeratosis

10. Hypervitaminosis A
Symptoms and signs:
Fatigue,malaise,anorexia,vomiting,headache and
diplopia
Dermatitis
Skeletal decalcification
Tenderness of long bones
Hepatomegaly

11. Carotenemia

12. Treatment
Children 1-6 yr and above
• Immediately on diagnosis - 2 lakh IU
• Following day - 2 lakh IU
• Four weeks later - 2 lakh IU
Children <1yr and <8kg(at any age)
• <6 months - 50,000 IU
• 6-12 months - 1 lakh IU
For night blindness and Bitot spots
Daily dose( 2 wks) -10,000 IU

13. Prevention
National Prophylaxis Vitamin A Program
Ministry of Health and Family Welfare
• Children(1-5 yr) - 2 lakh IU, every 6 months
• 9 months – 1 lakh IU
• 15 months – 2 lakh IU