Night Blindness as a Criterion of Vitamin a Deficiency: Review of the Literature With Preliminary Observations of the Degree and Prevalence of Vitamin a Deficiency Among Adults in Both Health and Disease

Article1 March 1937NIGHT BLINDNESS AS A CRITERION OF VITAMIN A DEFICIENCY: REVIEW OF THE LITERATURE WITH PRELIMINARY OBSERVATIONS OF THE DEGREE AND PREVALENCE OF VITAMIN A DEFICIENCY AMONG ADULTS IN BOTH HEALTH AND DISEASEHAROLD JEGHERS, M.D.HAROLD JEGHERS, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-10-9-1304 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptIn contrast to the hundreds of papers concerning the experimental, chemical, and pathological aspects of vitamin A deficiency are the small number of clinical studies. Such clinical investigations as are available deal, for the most part, with infants and children; and until recently, the manifestations of deficiency in adults have been overlooked or ignored.1, 2, 3Probably few physicians in this country are aware that there are now available several methods of quantitatively estimating the degree of vitamin A deficiency in humans, and further that some of these methods are simple enough for routine clinical use. Investigations in Europe and...Bibliography1. FRANDSEN H: Hemeralopia as an early criterion of A-avitaminosis and clinical symptoms and treatment of this disease, Acta. ophth., 1935, supp. 4, 1-160. Google Scholar2. SWEETK'ANG LKHJ: Clinical and anatomic study of avitaminosis A among the Chinese, Am. Jr. Dis. Child., 1935, l, 699-734. Google Scholar3. EDMUNDCLEMMESEN CSV: On deficiency of A vitamin and visual dysaptation, 1936, Oxford University Press, London, 1-77. Google Scholar4. JEANSZENTMIRE PCZ: A clinical method for determining moderate degrees of vitamin A deficiency, Jr. Am. Med. Assoc., 1934, cii, 892-895. CrossrefGoogle Scholar5. SANDLER AS: Carotene in prophylactic pediatrics, Arch. Pediat., 1935, lii, 391-406. Google Scholar6. PARK IO: Preliminary observations on vitamin A deficiency as shown by studies with the visual photometer, Jr. Oklahoma State Med. Assoc., 1935, xxviii, 359-364. Google Scholar7. PARK IO: Further observations on vitamin A deficiency as shown by studies with the visual photometer and clinically, Jr. Oklahoma State Med. Assoc., 1936, xxix, 129-141. Google Scholar8. Reports of the Council of the Am. Med. Assoc.: The status of certain questions concerning vitamins, Jr. Am. Med. Assoc., 1936, cvi, 1732-1735. Google Scholar9. MENDEL LB: Vitamin A, Jr. Am. Med. Assoc., 1932, xcviii, 1981-1987. CrossrefGoogle Scholar10. Editorial: Quantitative conversion of carotene to vitamin A, Jr. Am. Med. Assoc., 1933, c, 1038-1039. Google Scholar11. DRUMMONDBELLPALMER JCMEET: Absorption of carotene and vitamin A, Brit. Med. Jr., 1935, i, 1208-1210. CrossrefGoogle Scholar12. OLCOTTMCCANN DCDC: The transformation of carotene to vitamin A in vitro, Jr. Biol. Chem., 1931, xciv, 185-193. Google Scholar13. MOORE T: Vitamin A reserves of the human liver in health and disease, Lancet, 1932, ii, 669-674. CrossrefGoogle Scholar14. ROWNTREE JI: A study of the absorption and retention of vitamin A in young children, Jr. Nutr., 1930, iii, 265-287. CrossrefGoogle Scholar15. GREEN HN: Vitamin A content of the liver in puerperal sepsis, Lancet, 1932, ii, 723-726. CrossrefGoogle Scholar16. HESSLEWISBARENBERG AFJMLH: Does our dietary require vitamin A supplement, Jr. Am. Med. Assoc., 1933, ci, 657-663. CrossrefGoogle Scholar17. WILBUREUSTERMAN DLGB: Nutritional night blindness, Jr. Am. Med. Assoc., 1934, cii, 364-366. CrossrefGoogle Scholar18. WENDT H: Schilddrüse und Vitamin A, Med. Klin., 1936, i, 27-29. Google Scholar19. EDMUNDCLEMMESEN CSV: On parenteral A vitamin treatment of dysaptatio (nyctalo-hemeralopia) in some pregnant women, Acta. med. Scandinav., 1936, lxxxix, 69-92. Google Scholar20. ALTSCHULE MD: Vitamin A deficiency in spite of an adequate diet in congenital atresia of bile ducts and jaundice, Arch. Path., 1935, xx, 845-856. Google Scholar21. BLACKFANWOLBACH KDSB: Vitamin A deficiency in infants, Jr. Pediat., 1933, iii, 679-706. CrossrefGoogle Scholar22. EUSTERMANWILBUR GBDL: Clinical aspects of vitamin A deficiency, Jr. Am. Med. Assoc., 1932, xcviii, 2054-2060. CrossrefGoogle Scholar23. WOLBACHHOWE SBPR: Tissue changes following deprivation of fat-soluble A vitamin, Jr. Exper. Med., 1925, xlii, 753-777. CrossrefGoogle Scholar24. WOLBACHHOWE SBPR: Epithelial repair in recovery from vitamin A deficiency—An experimental study, Jr. Exper. Med., 1933, lvii, 511-526. CrossrefGoogle Scholar25. GOLDBLATTBENISCHEK HM: Vitamin A deficiency and metaplasia, Jr. Exper. Med., 1927, xlvi, 699-707. CrossrefGoogle Scholar26. GRINKERKANDEL RRE: Experiment vitamin (A, B1, B2 and B complex) deficiency: histologic changes in the central nervous system, Arch. Neurol. and Psychiat., 1933, xxx, 1287-1297. CrossrefGoogle Scholar27. WILSONDUBOIS JRRO: Report of a fatal case of keratomalacia in an infant, with postmortem examination, Am. Jr. Dis. Child., 1923, xxvi, 431-446. Google Scholar28. THATCHER HS: The pathology of avitaminosis, Southern Med. Jr., 1934, xxvii, 1023-1032. CrossrefGoogle Scholar29. FRAZIERHU CNC: Nature and distribution according to age of cutaneous manifestation of vitamin A deficiency, Arch. Derm. and Syph., 1936, xxxiii, 825-852. CrossrefGoogle Scholar30. SPENCE JC: A clinical study of nutritional xerophthalmia and night blindness, Arch. Dis. Child., 1931, vi, 17-26. CrossrefGoogle Scholar31. AYKROYD WR: Beriberi and other food-deficiency diseases in Newfoundland and the Labrador, Jr. Hyg., 1930, xxx, 357-387. CrossrefGoogle Scholar32. PILLAT A: The main symptoms of the eye in vitamin A deficiency in adults, Nat. Med. Jr. China, 1929, xv, 614-620. Google Scholar33. PILLAT A: Does keratomalacia exist in adults? Arch. Ophth., 1929, ii, 256-287 and 399-415. CrossrefGoogle Scholar34. WRIGHT RE: Keratomalacia in Southern India, Brit. Jr. Ophth., 1922, vi, 164-175. CrossrefGoogle Scholar35. JOHN I: Disturbances of sensibility of the cornea and conjunctiva in xerosis and keratomalacia of adults, with contribution to explanation of genesis of these diseases, Arch. Ophth., 1931, v, 374-391. CrossrefGoogle Scholar36. LOEWENTHAL LJ: A new cutaneous manifestation in the syndrome of vitamin A deficiency, Arch. Dermat. and Syph., 1933, xxviii, 700-708. CrossrefGoogle Scholar37. GOODWIN GP: A cutaneous manifestation of vitamin A deficiency, Brit. Med. Jr., 1934, ii, 113-114. CrossrefGoogle Scholar38. MACKAY H: Present knowledge of the clinical effects of vitamin A deficiency, with special reference to children, Arch. Dis. Child., 1934, ix, 65-90. CrossrefGoogle Scholar39. BERGLUNDKEEFERYANG HCSCS: Deficiency anemia in Chinese, responding to cod-liver oil, Proc. Soc. Exper. Biol. and Med., 1929, xxvi, 418-421. CrossrefGoogle Scholar40. Report of the Council of the Am. Med. Assoc.: Vitamin A and urinary lithiasis, Jr. Am. Med. Assoc., 1935, cv, 1983-1985. Google Scholar41. WRIGHTFROSSTPUCHELLAWRENCE HPJBFMR: Vitamin A and the common cold, Canad. Med. Assoc. Jr., 1931, xxv, 412-416. Google Scholar42. THORSON JA: Nutritional xerophthalmia, Jr. Am. Med. Assoc., 1934, ciii, 1438-1440. CrossrefGoogle Scholar43. DAVIS WT: Xerophthalmia: report of a case, Jr. Am. Med. Assoc., 1932, xcviii, 1640-1641. CrossrefGoogle Scholar44. CROHNROSENBERG BBH: Medical treatment of chronic ulcerative colitis, Jr. Am. Med. Assoc., 1924, lxxxiii, 326-330. CrossrefGoogle Scholar45. WOHL MG: Avitaminosis in course of diabetes, Jr. Am. Med. Assoc., 1926, lxxxvii, 901-906. CrossrefGoogle Scholar46. EDMUND C: Dysaptatio visualis, Trans. Ophth. Soc. U. Kingdom, 1932, lii, 249-257. Google Scholar47. AYKROYD WR: Functional night blindness due to vitamin A deficiency, Lancet, 1930, i, 824. Google Scholar48. AYKROYD WR: Night blindness due to vitamin deficiency, Trans. Ophth. Soc. U. Kingdom, 1930, l, 230-233. Google Scholar49. ADAMS D: Dark adaptation, Medical Research Council, London, 1929; Special Report Series 127, pp. 1-138. Google Scholar50. FRIDERICIAHOLM LSE: Experimental contribution to the study of the relation between night blindness and malnutrition: influence of deficiency of fat-soluble A vitamin in the diet on the visual purple in the eyes of rats, Am. Jr. Physiol., 1925, lxxiii, 63-78. CrossrefGoogle Scholar51. TANSLEY K: The regeneration of visual purple—its relation to dark adaptation and night blindness, Jr. Physiol., 1931, lxxi, 442-458. CrossrefGoogle Scholar52. WALD G: Vitamin A in eye tissues, Jr. Gen. Physiol., 1935, xviii, 905-915. CrossrefGoogle Scholar53. YUDKIN AM: Vitamins—clinical evidence of necessity of vitamins for function of ocular tissue, Arch. Ophth., 1935, xiv, 112-126. CrossrefGoogle Scholar54. WALD G: Carotenoids and the vitamin A cycle in vision, Nature, 1934, cxxxiv, 65. CrossrefGoogle Scholar55. WALD G: Carotenoids and the visual cycle, Jr. Gen. Physiol., 1935, xix, 351-371. CrossrefGoogle Scholar56. HOLCOMB RC: Night blindness, Jr. Am. Med. Assoc., 1934, cii, 786-787. Google Scholar57. BIRCH-HIRSCHFELD A: Über Nachtblindheit im Kriege, Arch. f. Ophth., 1916, xcii, 273-341. Google Scholar58. BIRNBACHER T: Quoted by Frandsen.1 Google Scholar59. JEGHERS H: Night blindness due to vitamin A deficiency: a consideration of its importance in traffic problems, New England Jr. Med., 1937, ccxvi, 51-57. CrossrefGoogle Scholar60. VIGNALON P: L'hemeralopie et le permis de conduire, J. de med. de Bordeaux, 1933, cx, 692-693. Google Scholar61. ROLLET J: Accidents d'automobile et hemeralopia, Arch. d'opht., 1934, li, 73-75. Google Scholar62. TILDERQUIST DL: Eye manifestation of A vitaminosis, Minnesota Med., 1933, xvi, 675-678. Google Scholar63. MASON RE: Minimal visual requirements for safe automobile driving, Jr. Missouri State Med. Assoc., 1935, xxxii, 367-369. Google Scholar64. HOLM E: Demonstration of hemeralopia in rats nourished on food devoid of fat-soluble A-vitamin, Am. Jr. Physiol., 1925, lxxiii, 79-84. CrossrefGoogle Scholar65. BLOCH CE: Effects of deficiency of vitamins in infancy, Am. Jr. Dis. Child., 1931, xlii, 263-278. Google Scholar66. BLEGVAD O: Xerophthalmia, keratomalacia and xerosis conjunctivae, Am. Jr. Ophth., 1924, vii, 89-117. CrossrefGoogle Scholar67. WIDMARK E: Vitamin A deficiency in Denmark and its results, Lancet, 1924, i, 1206-1209. CrossrefGoogle Scholar68. EDMUND C: Some methods of testing dark vision, Acta. Ophth., 1925, iii, 153-169. Google Scholar69. PILLAT A: Quoted by Yudkin.53 Google Scholar70. KIANG SM: Some observations on the visual field in various forms of vitamin A deficiency, Nat. Med. Jr. China, 1932, xviii, 827-834. Google Scholar71. FRIDERICHSEN C: Quantitative investigations of the resorption of A vitamin in a case of coeliakie, Acta. Paediat., 1936, xviii, 377-391. CrossrefGoogle Scholar72. JEANSZENTMIRE PCZ: The prevalence of vitamin A deficiency among Iowa children, Jr. Am. Med. Assoc., 1936, cvi, 996-997. CrossrefGoogle Scholar73. HESSKIRBY AFDB: The incidence of xerophthalmia and night blindness in the United States—a gauge of vitamin A deficiency, Am. Jr. Pub. Health, 1933, xxiii, 935-938. CrossrefGoogle Scholar74. MCLESTER JS: Quoted in Editorial.75 Google Scholar75. EDITORIAL: Latent avitaminosis, Jr. Am. Med. Assoc., 1933, ci, 127-128. Google Scholar76. DALLDORF G: A sensitive test for subclinical scurvy in man, Am. Jr. Dis. Child., 1933, xlvi, 794-802. Google Scholar77. EDITORIAL: Subclinical scurvy, Jr. Am. Med. Assoc., 1934, cii, 374-375. Google Scholar78. ABTFARMEREPSTEIN AFCJIM: Normal cevitanic (ascorbic) acid determinations in blood plasma and their relationship to capillary resistance, Jr. Pediat., 1936, viii, 2-20. Google Scholar79. BLEGVAD O: Quoted by Altschule.20 Google Scholar80. BLOCH CE: Further clinical investigations into diseases arising in consequence of deficiency in fat-soluble A factor, Am. Jr. Dis. Child., 1924, xxviii, 659-667. Google Scholar81. GAMBOA L: Deficiency in vitamin A and nyctalopia, Jr. Philippine Islands Med. Assoc., 1930, x, 235-238. Google Scholar82. FRIDENBERG P: Night blindness, Jr. Am. Med. Assoc., 1934, cii, 951. CrossrefGoogle Scholar83. JEANSBLANCHARDZENTMIRE PCEZ: Dark adaptation and vitamin A, Jr. Am. Med. Assoc., 1937, cviii, 451-458. CrossrefGoogle Scholar84. CARRPRICE FHEA: Colour reactions attributed to vitamin A, Biochem. Jr., 1926, xx, 497-501. CrossrefGoogle Scholar85. SCHNEIDERWIDMANN EE: Der Carotin und Vitamin A Spiegel im menschlichen Serum, Klin. Wchnschr., 1935, xiv, 670-673. CrossrefGoogle Scholar86. BLACKFAN K: Progress in the early recognition of vitamin deficiency states, New England Jr. Med., 1936, ccxv, 1159-1162. CrossrefGoogle Scholar87. YOUMANS JB: The present status of vitamin deficiencies in practice, Jr. Am. Med. Assoc., 1937, cviii, 15-20. CrossrefGoogle Scholar88. FRIDERICHSENEDMUND CC: Studies of hypovitaminosis A: II. A second method for testing the resorption of vitamin A from medicaments, Am. Jr. Dis. Child., 1937, liii, 89-109. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: Boston, Massachusetts*Received for publication October 29, 1936.From the Fifth (Boston University) Medical Service, Boston City Hospital, and The Department of Medicine, Boston University School of Medicine, Boston, Mass.Aided by a grant from the Committee on Scientific Research of the American Medical Association. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byMalnutrition: A Global ProblemHarold Joseph JeghersNutritional Deficiencies and Brain DevelopmentDie Krankheiten der Leber und der GallenwegeLIVER FUNCTION IN DARIER'S DISEASE AND PITYRIASIS RUBRA PILARISThe Chemistry and Physiology of Vitamin AÜber Vorkommen und Ausmass Wirklichen Vitamin A-MangelsBiophotometric studies in 30 cases of chronic ulcerative colitisUntersuchungen über HemeralopieA-Vitamin und Luftwegsinfektionen.Avitaminosen und HypovitaminosenVitamin A and Rod-Cone Dark Adaptation in Cirrhosis of the LiverVitamin A research and its clinical applications in pediatricsLe Vitamine nei loro rapporti con l'oftalmologiaThe follicular lesions of vitamine a and c deficiencies: a critical surveyNUTRITION SURVEYS : VITAMIN-A DEFICIENCY AMONG SCHOOL-CHILDREN IN LONDON AND CAMBRIDGE 1 March 1937Volume 10, Issue 9Page: 1304-1334KeywordsBlindnessChildrenHospital medicineInfantsMedical servicesVitamin A Issue Published: 1 March 1937 PDF downloadLoading ...