Nutritional Optic Neuropathy: Bariatric Surgery Gone Wrong

Area of Science:

• Ophthalmology
• Neurology
• Nutritional Science

Background:

• Malnutrition following bariatric surgery can lead to various deficiencies.
• Nutritional optic neuropathies are rare but serious complications of malnutrition.

Observation:

• A 52-year-old woman presented with bilateral central vision blurring, reduced visual acuity, and red-green color deficiency.
• Ophthalmic and neuroimaging examinations were unremarkable, but visual field testing revealed bilateral central scotoma.

Findings:

• Laboratory results indicated significantly low serum copper levels, consistent with copper deficiency.
• The patient was diagnosed with nutritional optic neuropathy secondary to malnutrition.

Implications:

• Treatment with total parenteral nutrition including copper and oral supplements led to visual and color vision recovery.
• Despite treatment, persistent bilateral central scotoma highlights potential long-term visual deficits from nutritional optic neuropathy.