Adult blindness secondary to vitamin A deficiency associated with an eating disorder

We examined an adult patient who lost one eye due to severe keratomalacia secondary to self-induced vitamin A deficiency.

This case report provides a clinical, ophthalmologic, and laboratory description in addition to a review of the medical literature.

A 33-y-old woman with a 17-y history of an eating disorder presented with bilateral conjunctival xerosis, an infected corneal ulcer in the right eye and a large descemetocele in the left eye. Laboratory and clinical findings were consistent with vitamin A deficiency. Despite a tectonic penetrating keratoplasty, her left eye perforated and had to be eviscerated. In parallel, vitamin A replacement improved her clinical status and the ocular findings in her right eye.

The present report indicates that vitamin A deficiency secondary to eating disorders should be considered in the differential diagnosis of patients with severe dry eye and corneal ulceration.