Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2014
Xerophthalmia and keratomalacia secondary to diet-induced vitamin A deficiency in Scottish adults.
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Lai Ken Lee, Ng Jia Yu, Srinivasan Sathish
Аннотация
OBJECTIVE: To report the ocular features, underlying systemic conditions, and management of diet-induced vitamin A deficiency in Scottish adults.
DESIGN: Retrospective case series.
METHODS: Three middle-aged white adults presented with ocular signs of xerophthalmia and keratomalacia that led to the diagnosis of previously undiagnosed vitamin A deficiency. Case 1 presented with rapidly progressing bilateral keratomalacia with corneal perforation, whereas Cases 2 and 3 presented with conjunctival and corneal xerosis.
RESULTS: Corneal gluing was performed in Case 1. Cases 2 and 3 were treated topically with preservative-free tears, retinoic acid, and punctual plugs to optimize the ocular surface. This, combined with dietary supplementation, resulted in normalizing the ocular surface.
CONCLUSIONS: Diet-induced vitamin A deficiency can occur in middle-aged white adults. Ocular surface changes may be the presenting sign of hypovitaminosis A in the Western world. A high degree of suspicion with prompt recognition and management of the underlying dietary deficiency can lead to complete reversal of the ocular surface changes.
DESIGN: Retrospective case series.
METHODS: Three middle-aged white adults presented with ocular signs of xerophthalmia and keratomalacia that led to the diagnosis of previously undiagnosed vitamin A deficiency. Case 1 presented with rapidly progressing bilateral keratomalacia with corneal perforation, whereas Cases 2 and 3 presented with conjunctival and corneal xerosis.
RESULTS: Corneal gluing was performed in Case 1. Cases 2 and 3 were treated topically with preservative-free tears, retinoic acid, and punctual plugs to optimize the ocular surface. This, combined with dietary supplementation, resulted in normalizing the ocular surface.
CONCLUSIONS: Diet-induced vitamin A deficiency can occur in middle-aged white adults. Ocular surface changes may be the presenting sign of hypovitaminosis A in the Western world. A high degree of suspicion with prompt recognition and management of the underlying dietary deficiency can lead to complete reversal of the ocular surface changes.