A simple surveillance system for xerophthalmia and childhood corneal ulceration

A simple cost-effective surveillance system is described for reporting cases of xerophthalmia and childhood corneal ulceration. The system is suitable for use by ophthalmic auxiliaries in developing countries. Presented are the results of a 2-year surveillance involving 15 hospitals in 11 areas of the United Republic of Tanzania. Cases of xerophthalmia in its early stages (characterized by night blindness or Bitot's spots) were found in all areas surveyed. Of almost 300 cases of unilateral and bilateral corneal ulceration, 46% and 79%, respectively, followed a recent infection with measles. The single most important cause of bilateral corneal ulceration was vitamin A deficiency. The surveillance system has proved to be particularly useful as a first step in defining the type and distribution of serious corneal disease in children.