Clinical Review & Education Special Communication Preventing Blindness and Saving Lives The Centenary of Vitamin A Alfred Sommer, MD, MHS Within 20 years of its discovery 100 years ago, vitamin A was recognized as critical to normal eyes, growth, and survival. Clinical interest subsequently contracted to its importance in preventing xerophthalmia, until this ophthalmologist stumbled, quite accidently, on its role in fighting life-threatening infections. Repeated, large-scale randomized clinical trials eventually Author Affiliation: Johns Hopkins convinced (and reminded) the pediatric and nutrition communities of its importance for child Bloomberg School of Public Health, survival. Vitamin A distribution programs are now credited with saving the sight and lives of Baltimore, Maryland. nearly half a million children every year. Corresponding Author: Alfred Sommer, MD, MHS, Johns Hopkins Bloomberg School of Public Health, JAMA Ophthalmol. 2014;132(1):115-117. doi:10.1001/jamaophthalmol.2013.5309 615 N Wolfe St, Ste E6527, Baltimore, MD 21205 (
[email protected]). he first 2 decades of the 20th century witnessed a revolu- Organization’s(WHO)officiallyrecommendedtreatmentwithwater- tion in nutritional science. Hopkins1 and then Funk2 popu- miscible, injectable vitamin A (which was not even commercially T larized the notion that animals could not survive on fat, pro- available at the time!).15,16 tein, and carbohydrates alone, recognizing that small amounts of The latter discovery was my first lesson that data alone do not other substances, so-called accessory factors or vital amines (be- change global health policy.8 These treatment trial data were pre- cause they were erroneously thought to be nitrogen-containing de- sented at a WHO/United Nations Children’s Fund (UNICEF) meet- rivatives of ammonia), were required for growth and survival.