Qasim Rahopoto, Suhail A Almani, Muzaffar A Shaikh, Iqbal Shah, Narinder Maheshwari, Ghulam Hussain Baloch, Kumar Lal.
Frequency of night blindness in Cirrhosis and effective restoration of vision with vitamin A therapy.
J Liaquat Uni Med Health Sci Jan ;7(2):75-78.

OBJECTIVE: To determine the frequency of night blindness among cirrhotic patients and evaluate the restoration of vision with vitamin A therapy. DESIGN: - Case-control observational study. SETTING: Medical ward of Liaquat University Hospital Hyderabad / Jamshoro, Sindh – Pakistan; from January 2006 to December 2007. METHODS: Two hundred cirrhotic patients admitted at medical unit IV were enrolled in the study. The non-cirrhotic patients were excluded. Fifty healthy volunteers took part as the control subjects. RESULTS: Out of 200 patient, 116(58%) were males and 84(42%) females. The mean age of the cirrhotic patients was 48.46 + 11.97 years. The cause of cirrhosis was hepatitis C virus in 146(73%) cases, hepatitis B virus in 19(9.5%) cases, hepatitis C and B virus in 7(3.5%) cases, non B and C virus in 24(12%) cases and alcohol in 4(2%) cases. When cirrhotic patients were grouped into Child-Pugh`s score, 44(22%) were in class A, 106 (53%) in class B and 50(25%) in class C. Among 200 patients, 122 (61%) had history of night blindness and 25(12.5%) had the colour blindness. Restoration of vision was observed in 105(86%) patients with vitamin A therapy (tablet Vitamin A 50,000 IU, Wilson Pharma), twice daily, for 6 weeks time. CONCLUSION: The history of night blindness and its restoration of vision with vitamin A therapy is a rough indicator of vitamin A deficiency in cirrhotic patients. The larger studies are required especially RBP (plasma retinol binding protein) and serum vitamin A concentration before recommendation of vitamin A replacement. The Ophthalmic changes in cirrhotic patients are preventable and treatable.

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