H18.44
Keratomalacia
Clinical Classification Guidelines
Excludes Type 1
- keratomalacia due to vitamin A deficiency (E50.4)
Medical Intelligence & Overview
Keratomalacia is a severe eye condition characterized by the softening and destruction of the cornea, the transparent front part of the eye. This condition can lead to significant vision impairment or blindness if not properly managed. It primarily results from vitamin A deficiency, which is vital for maintaining healthy eye tissues and vision. Recognizing the signs and understanding the causes and treatment options are important for preventing permanent eye damage.
Causes & Symptoms
Clinical Causes: Vitamin A deficiency, especially in regions with limited access to nutritious food. Malabsorption syndromes such as celiac disease or chronic diarrhea, which impair nutrient absorption. Liver diseases affecting vitamin A storage and metabolism. Inadequate dietary intake of vitamin A-rich foods like liver, dairy, and green leafy vegetables. Infections or conditions that increase vitamin A requirements or cause depletion.
Key Symptoms: Night blindness, difficulty seeing in low light. Dryness of the eye and conjunctiva (xerophthalmia). Corneal clouding or opacity. Progressive erosion and ulceration of the cornea. Severe cases may cause corneal perforation or complete loss of vision. Blepharospasm or involuntary eyelid spasms. Sense of a foreign body in the eye.
Diagnostic & Treatment
Diagnosis Path: Diagnosis is mainly clinical, based on physical examination of the eye revealing signs such as corneal ulceration and dryness. Additional tests may include slit-lamp examination, which allows detailed visualization of the cornea, and assessment of vitamin A levels in the blood. Patient history regarding nutritional intake and gastrointestinal health is also important to identify underlying causes.
Treatment Protocols: Administering vitamin A supplements under medical supervision. Addressing underlying nutritional deficiencies with diet modifications. Treating any eye infections or complications with appropriate medications. Providing supportive care such as artificial tears or ointments to relieve dryness. In severe cases, surgical intervention may be necessary, including corneal transplantation.
Clinical Advice & FAQs
Billing Guidance
Is H18.44 a billable ICD-10 code?
Yes, H18.44 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report H18.44?
Clinical documentation must specify the nature of Keratomalacia and any associated comorbidities for accurate reporting.
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