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In the preface to this monograph, the author states that approximately 0.5 million children in depressed populations in developing countries have severe xerophthalmia and that another 5 to 10 million children have milder forms of xerophthalmia. It can also affect persons with liver disease, malnutrition, and malabsorptive states (eg, diarrhea). To provide a more complete study of the epidemiologic, clinical, therapeutic, and pathologic aspects of the disorder, the author undertook a three-year research program in Indonesia.
Retinol (an alcohol form of vitamin A) is formed in the small intestine from either provitamin A carotenoids or fat-soluble vitamin A (retinyl palmitate), where it is absorbed systemically or stored in the liver. Because retinol is so important in the visual cycle of the photoreceptors of the retina, the author found that nightblindness, with impaired dark adaptation,
Hughes WF. Nutritional Blindness: Xerophthalmia and Keratomalacia. Arch Ophthalmol. 1983;101(2):308. doi:10.1001/archopht.1983.01040010310032