e We studied the appearance of the conjunctiva in 50 consecutive cases of vitamin A-responsive conjunctival xerosis (Xl) and 162 consecutive cases of nutritional keratopathy (corneal xerosis [X2] and stromal loss [X3]). Conjunctival extensive at or shortly after xerosis, the onset of frank corneal involvement, was present in 101 (95%) of 106 eyes of cases of X2 but in only 99 (64%) of 155 ulcerated/necrotic eyes (X3A and X3B). Forty-four percent of involved eyes were inflamed, the percentage

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... reasing with the severity of corneal disease. In 20 patients with nutritional keratopathy, conjunctival xerosis was monocular: inilammation was more preva:ent and corneal involvement more severe in the nonxerotic eyes. In patients with precipitous deterioration of vitamin A status, clinically recognizable alterations of the cornea sometimes developed before any changes appeared in the conjunctiva. (Arch Ophithalmol 1962;100:951-952) It is widely believed that xerophthal-