The pigmentation gives the conjunctiva a peculiar smoky appearance. Bitot's spots are glistening white plaques formed of desquamated thickened conjunctival epithelium, usually triangular in shape and firmly adherent to the underlying conjunctiva. When dryness spreads to the cornea it takes on a dull, hazy, lackluster appearance. Later the cornea undergoes necrosis and ulceration, so-called keratomalacia. Children between the ages of 1 and 5 years are most commonly affected.
Breast milk is virtually the only source of vitamin A the first few months for many infants.
A nutriture for no more than a few weeks. Although vitamin A concentration in human milk is dependent on the mother's vitamin A status, vitamin A deficiency is rare among breastfed infants, even in parts of the world where vitamin A deficiency is endemic. Measles, one of the six major childhood diseases, rapidly reduces blood levels of vitamin A and frequently precipitates xerophthalmia. Retinol is chiefly found in milk, butter, cream, cheese, egg yolk, liver, kidneys and some of the fatty fish. Carotene is widely distributed among plant foods.