Vitamin A Deficiency

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Disease

  • Xerophthalmia refers to the spectrum of ocular diseases resulting from a deficiency in Vitamin A

Causes

  • Malnutrition, malabsorption (especially after gastric bypass surgery), chronic alcoholism, highly selective diets

Symptoms

  • Night blindness, vision loss, general decline in health

Findings

  • Conjunctiva:
    • Squamous metaplasia and keratinization
    • Bitot’s spots: Triangular areas of foamy, keratinized epithelium in the palpebral fissure, caused by infection with Corynebacterium xerosis
  • Cornea:
    • Punctate epithelial erosions, keratinization, keratomalacia (sterile corneal melting due to colliquative necrosis)
  • Retina:
    • Yellowish spots in the periphery in advanced stages
    • Associated with reduced amplitude in electroretinography (ERG)

Treatment

  • Systemic supplementation of Vitamin A (200,000 IU oral liquid, oil based preparation or intramuscularly 100,000 IU water-solution).
  • Local lubricating therapy

Sources

  • AAO Vitamin A Deficiency
  • The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease; Kalla Gervasio MD, Travis Peck MD et al; Lippincott Williams&Wilkins; 8th Edition (2021)
  • Kanski’s Clinical Ophthalmology: A Systematic Approach; John E Salmon MD; Elsevier; 9th Edition (2019)