Bitot's Spots

Information on bitot's spots and night blindness as a result of vitamin a deficiency.

causes of night blindness

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  1. What are Bitot’s Spots?
  2. Diagnosing Bitot’s Spots
  3. What Causes Bitot’s Spots?
  4. Help for Bitot’s Spots
  5. More Information on Bitot’s Spots

What are Bitot’s Spots?

Bitot’s Spots are distinct white patches that appear on the conjunctiva – the membrane that covers most of the visible part of the eye.

Bitot’s spots can expand and develop into a condition called xerophthalmia. Xerophthalmia is a major cause of blindness in children in Africa and Latin America, and usually occurs between the ages of 3-5 years old. It is generally associated with malnutrition and Vitamin A deficiency.

Bitot’s Spots look like raised triangular-shaped areas on the white area of the eyeball and ulcers can develop with the cornea softening and turning pulp-like if not treated, resulting in irreversible blindness.

Diagnosing Bitot’s Spots

The diagnosis of Bitot’s spots will be confirmed by an eye specialist or opthalmologist. Vitamin A status is measured by tests for retinol, with blood-serum retinol concentrations of 30-60 mg/dl considered in the normal range. Levels that fall below this range indicate Vitamin A deficiency.

Symptoms and Signs of Vitamin A Deficiency
  • Dry skin and hair
  • Increased incidence of ear infection, sinusitis, respiratory infection, urinary infection, and digestive problems
  • Drying of the cornea with ulceration – xerophthalmia
  • Inability to gain weight
  • Nervous disorders
  • Skin sores
  • There may be night blindness or a decreased ability for dark adaptation

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What Causes Bitot’s Spots?

This condition results from a buildup of keratinized epithelial debris and secretions that can be found in the conjunctiva. These spots are a sign of Vitamin A deficiency and are usually accompanied by night blindness.

Help for Bitot’s Spots

Treating Bitot’s spots first and foremost involves improving the individual’s diet. Regular and adequate intake of foods rich in Vitamin A can reduce symptoms of Bitot’s spots such as night blindness. Other medical conditions such as respiratory tract infections, diarrhea and measles that may be present should also be treated immediately.

Usually, topical antibiotics are administered to prevent secondary bacterial infection. Vitamin A deficiency and the early stages of xerophthalmia can be reversed by administration of a massive does (200,000 IU or 110 mg of retinol palmitate) orally on two successive days. Children with corneal ulcers should receive vitamin A whether or not a deficiency is suspected. 

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More Information on Bitot’s Spots

Preventing Bitot’s Spots

In order to prevent Bitots spots, there are certain lifestyle changes that need to be adhered to and they include:

  • Increase your intake of Vitamin A supplements and beta-carotene
  • A protein rich diet is essential and should include meat, liver, eggs, milk, dairy products and vegetables
  • Drink fresh carrot juice to prevent or alleviate some eye problems
  • Two tablespoons of cod liver oil taken daily is also rich in vitamin A
  • Avoid straining your eyes
  • Avoid smoke-filled rooms
  • Protect your eyes from direct and indirect sunlight

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Bitot’s Spots and Pregnancy

It is possible to overdose on Vitamin A, and this is especially important to be careful of during pregnancy. Excessive quantities of Vitamin A intake during pregnancy may have a teratogenic effect as a result of two metabolites, trans-retinoic acid – RA, tretinoin and 13-cis retinoic acid-CRA, isotretinoin.

Pregnant women are therefore strongly advised against eating too much liver, a rich source of Vitamin A, as it may have harmful effects on the fetus. Eating a well balanced diet and taking Vitamin A supplements under the supervision of a healthcare provider should ensure a healthy pregnancy.

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