Abstract
Purpose: :
Whereas vitamin A deficiency remains a leading cause of preventable blindness worldwide, in the United States, it has only rarely been reported within the past two decades. The purpose of this study was to present a series of patients in the United States who presented with ocular surface disease that we subsequently found to be secondary to Vitamin A deficiency.
Methods: :
This was a retrospective case series and medical record review of patients who presented to two institutions over a two-year period with severe ocular surface disease and who were subsequently found to be severely vitamin A deficient. Information on systemic illness, initial ophthalmologic presentation, clinical course, management, and vitamin A serum levels was collected.
Results: :
Five patients presenting with ocular surface disease were found to have vitamin A deficiency. Two patients were autistic children who were severely malnourished secondary to a diet limited to potatoes, and one patient was a severely malnourished adult. Two other patients had primary biliary cirrhosis and a history of vitamin A deficiency documented by low serum levels of vitamin A. Two of these five patients developed corneal perforation, necessitating urgent corneal gluing followed by keratoplasty. All patients manifested severe dry eyes. All patients underwent intensive systemic vitamin A supplementation with improvement in their ocular surface status.
Conclusions: :
Ocular surface disease secondary to Vitamin A deficiency is a serious, preventable, and potentially blinding eye condition that still exists in the developed world. Especially in autistic children and individuals with end stage liver disease, a heightened awareness of this entity is warranted.
Keywords: vitamin A deficiency • cornea: tears/tear film/dry eye • cornea: epithelium