Bilateral Keratomalacia From Vitamin A Deficiency in Pancreatic Insufficiency

While vitamin A deficiency is a leading cause of blindness globally, it is uncommon in the developed world. Here we describe the unique presentation of a young man in the United States with keratomalacia from vitamin A deficiency related to pancreatic insufficiency. The patient presented with bilateral blurry vision that persisted for two weeks, significant unintentional weight loss, orthostatic hypotension, and profuse diarrhea. Upon slit-lamp examination, bilateral corneal opacities were appreciated. After completing additional testing, it became clear that the patient's corneal opacities were related to vitamin A deficiency from pancreatic insufficiency.