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To the Editor:
—Dr. Sumner Liebman has asked me to comment on the letter from Dr. Victor C. Rambo relating to Dr. Liebman's article on ocular manifestations of the Riley-Day syndrome.It is quite understandable that Dr. Rambo should be impressed with the similarity between the ocular manifestations in familial dysautonomia as described by Dr. Liebman and those present in vitamin A deficiency. As the physician concerned with the care of a child described in Dr. Liebman's article, I can assure you that our immediate attention was drawn to the possibility of vitamin A deficiency, as soon as the ocular manifestations became apparent. The child had received 7000 units of vitamin A since birth as part of a multivitamin preparation. This dose had been increased at the time of initial ocular manifestations to 75,000 units of vitamin A intramuscularly daily for a long period of time without any effect except