In India, VAP was started in 1970 as a program with the specific aim of preventing nutritional blindness due to vitamin A deficiency. We shall therefore restrict further discussion to Bitot s spot prevalence only. The District Nutrition Project of Indian Council of Medical Research recently carried out a survey on status of VAD in 16 districts in India. Dr. Swami and Dr. Thakur carried out the study amongst the most disadvantaged population in a small area only. The result of their study, therefore, cannot be extrapolated for the whole country.
Infectious keratitis is considered the major cause of corneal opacification.
It is true that coverage of VAP is low in the country. The Nutrition Chapter, Indian Academy of Pediatrics has not agreed to linkage of megadose VAP with PPI primarily due to anticipated logistical issues. The staff gained the experience of administering vitamin A through an earlier round of campaign approach. This just indicates the enormity of training requirements, commitment and probably involvement of multilateral agencies in meticulous planning even for a state level program. While there will be need to train pulse polio workers which include nonmedical personnel in many areas, health workers carrying out routine services will have to be instructed to discontinue routine vitamin A administration.