Four Unique Cases of Keratopathy From Vitamin A Deficiency in a Tertiary Care Center in the United States: A Case Series.
Joshua Van Swol, Catherine Reppa
✦ AI-curated · Sources linked
Case in brief
A retrospective review at a tertiary center in the United States identified four patients with xerophthalmia and documented ocular findings. Their clinical contexts included malignancy, alcoholism, severe autism, and end-stage renal disease requiring dialysis. Presentations were often advanced, with severe keratopathy complicated by corneal perforation from sterile stromalysis or superimposed infection; one patient had a Bitot spot. The authors report that prompt recognition and vitamin A repletion can reverse or stabilize keratopathy, although patients in this series more often presented after substantial corneal damage had developed.
What made this case unusual
The cases show severe vitamin A deficiency–related corneal disease, including perforation, in a high-income-country tertiary center, across patients with varied medical and nutritional risk contexts.
Diagnostic / clinical pearl
Consider vitamin A deficiency in patients with keratopathy who have relevant medical or nutritional risk factors; ocular signs may be recognized only after substantial corneal damage has occurred.
Why it matters
The series highlights vitamin A deficiency as a preventable cause of vision loss that can still present with advanced corneal disease in high-income settings.