To the Editor.
—I read with interest the article entitled "Corneal Xerophthalmia and Keratomalacia" by Sommer and Sugana published in the March Archives (1982;100:404-411).This study would have been credible if only they had stated the results of their bacterial and fungal studies in the article, which they claimed they performed but, unfortunately, were not included in the article. According to Sommer and Sugana, "primary or secondary infection appears to play little role in the course of events" in keratomalacia. The beautiful colored pictures in their article are perfect examples of secondary bacterial corneal ulcerations seen not only in vitamin A xerophthalmia but also in other dry eye syndromes, eg, Sjögren's syndrome and Stevens-Johnson syndrome. The important role of secondary bacterial infection in vitamin A xerophthalmia has been proved both clinically and experimentally.1,2
Valenton MJ. Corneal Xerophthalmia and Keratomalacia. Arch Ophthalmol. 1982;100(12):1974. doi:10.1001/archopht.1982.01030040954022