title: Sociodemographic features and risk factor profile of keratomalacia in early infancy.
abstract: OBJECTIVE
  To study the clinical spectrum and etiopathogenesis of keratomalacia in infants younger than 6 months.
  
  
  METHODS
  Case records of children younger than 6 months presenting with keratomalacia to cornea services of a tertiary care ophthalmic center in India from June 2007 through April 2010 were reviewed. The parameters evaluated were age, sex, anthropometry, nutritional status, socioeconomic status, antenatal history, maternal nutrition, systemic associations, immunization, and dietary history. Comprehensive ocular examination with emphasis on ocular adnexa, conjunctiva, cornea, and anterior chamber was performed.
  
  
  RESULTS
  Overall, 33 infants (24 male and 9 female) with mean age of 2.8 ± 1.3 months (range = 1-6 months) were included. Eighty-eight percent (29 of 33) had associated protein energy malnutrition. A total of 31 of 33 children (94%) belonged to poor families, and nearly, three fourth of the children were not fully immunized as recommended for their age. Inadequate breastfeeding was the precipitating cause in 100%. Maternal nutritional status was poor in 82% of the cases. The reason for not breastfeeding the infant was inadequate milk production in 89.4% of mothers, 64.7% were ill informed, and 1 mother had adopted a child. Feeding practices included diluted cow's milk (1:1-1:5) in 21 infants (63.6%), toned dairy milk in 9 infants (27.3%), infant lactogen in 2 infants (6.1%), and skimmed milk powder in 1 infant (3.0%).
  
  
  CONCLUSIONS
  Keratomalacia in early infancy can be attributed to inadequate breastfeeding. Important contributory risk factors include lower socioeconomic status, poor maternal nutrition, and lack of knowledge about recommended feeding guidelines.
authors.affiliation: Cornea & Refractive Surgery Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Noopur
authors.initials: N
authors.lastname: Gupta
authors.forename: Radhika
authors.initials: R
authors.lastname: Tandon
mesh_terms: D003906:Developing Countries; D004467:Economics; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D007223:Infant; D007228:Infant Nutrition Disorders / Q000453:epidemiology; D008297:Male; D009752:Nutritional Status; D011502:Protein-Energy Malnutrition / Q000453:epidemiology; D012307:Risk Factors; D014802:Vitamin A Deficiency / Q000453:epidemiology* / Q000209:etiology