Blinding Malnutrition

While refractive errors and cataracts arguably benefit from correction by discrete and well-defined interventional strategies, other causes of blindness are affected by uniquely different key determinants, and present multifaceted challenges in their correction. Two such examples include blinding malnutrition, as well as infectious causes of vision impairment. Ironically, both these conditions may share similar aggravating, and reversible causes, and remain a public health concern in the global context of maldistribution of resources, food and access to medicines and vaccines. Diarrhea, worm infections and other intestinal disorders, for example, impair vitamin A absorption, while measles, respiratory tract infections and other febrile illnesses increase metabolic demands and interfere with normal appetite. Protein-energy malnutrition may be an added burden that interferes with the absorption, storage and utilization of vitamin A2. In developing a conceptual framework and interventional strategies to address blindness not caused by refractive errors or cataract, the inclusion of nutritional status, as well as infectious disease epidemiology of the host nation, may therefore be necessary.