Vitamin A Deficiency

Vitamin A deficiency is a lack of sufficient vitamin A in the diet, most commonly affecting young children and pregnant women. It is an important preventable cause of eye damage and increases the risk of severe illness and death from common childhood infections.

• Night blindness — difficulty seeing in low light — is often the earliest symptom
• Dry, foamy patches on the white of the eye (Bitot's spots)
• In more severe deficiency, dryness, clouding, and softening of the cornea, which can progress to permanent blindness if untreated
• Increased frequency and severity of infections, such as diarrhoea and measles, in affected children

• Inadequate dietary intake of vitamin A or foods rich in its precursors (such as orange and dark-green vegetables, and animal-source foods).
• Increased vitamin A requirements during rapid growth in childhood and during pregnancy and breastfeeding.
• Conditions that reduce absorption, such as chronic diarrhoea or malnutrition, increase risk.

• Often identified clinically through characteristic eye findings, such as night blindness or Bitot's spots, particularly in a young child from a food-insecure household.
• Assessment of dietary history and growth is part of a full nutritional evaluation.
• Laboratory measurement of blood vitamin A levels is not usually needed for routine diagnosis or management at primary care level.

Children diagnosed with clinical vitamin A deficiency are given a high-dose vitamin A supplement immediately, with a repeat dose the following day, following the national protocol.

Routine vitamin A supplementation is given periodically to all children in the recommended age range in vitamin A–deficient areas as a public health measure, regardless of symptoms.

Children with measles are given vitamin A as part of routine measles management, since measles increases the risk of vitamin A deficiency complications.

Dietary counselling encourages regular intake of vitamin A–rich foods, such as orange-fleshed fruits and vegetables, dark-green leafy vegetables, and, where accessible, animal-source foods like eggs, liver, and dairy.

Children with corneal changes or eye damage are referred urgently, as this represents a medical emergency for sight.

• Support routine vitamin A supplementation programmes for children in the recommended age range.
• Encourage regular consumption of vitamin A–rich foods within the household diet.
• Promote and support exclusive breastfeeding, which provides vitamin A to infants.
• Ensure prompt treatment of diarrhoea and other childhood illnesses that can worsen vitamin A status.