Xerophthalmia and keratomalacia secondary to diet-induced vitamin A deficiency in Scottish adults

作者：Lai Ken Lee; Ng Jia Yu; Srinivasan Sathish^*

来源：Canadian Journal of Ophthalmology, 2014, 49(1): 109-112.

DOI：10.1016/j.jcjo.2013.09.003

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.

• 出版日期2014-2