Anterior Segment Collagenase Activity in Children with Keratomalacia

The total proteins and collagenase activity in tears as well as α2-macroglobulin (anticollagenase) and vitamin A levels in serum, were estimated in 35 malnourished children with corneal lesions, in 30 malnourished controls (age matched) without corneal lesions, and in 19 normal children. Also eye swabs from some of the children were cultured for bacteria. Significant decreases in the serum vitamin A and α2-macroglobulin levels and in tear total protein levels were observed in malnourished children when compared with the normal values. Further, the reduction was more pronounced in children with corneal lesions than in those without them. Interestingly, the tear collagenase activity was significantly elevated in malnourished children with corneal lesions as compared with that in those without lesions or in normal children. Similarly, more bacteria could be cultured in samples from malnourished children (with/without corneal lesions) than in those from normal children. These observations clearly indicate that the elevated levels of anterior segment collagenase may play an important role in the pathogenesis of corneal lesions.