Keratomalacia in the cachectic hospitalized patient

Keratomalacia occurred in two cachectic hospitalized patients, each with severe vitamin A-protein deficiency secondary to a lethal disease. Prompt therapy with parenteral and topical vitamin A, protein supplementation, and a soft contact lens restored corneal integrity and prevented visual loss in one patient. Keratinization of the conjunctiva did not occur in either patient. Patients with severe protein deficiency may develop keratomalacia in the absence of a severely decreased serum level of vitamin A.