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
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.
Cirrhosis. Night Blindness. Child-Pugh’s Class. Vitamin A.