Keratomalacia in a Patient With Psychogenic Vitamin A Deficiency

Cornea
Sidney M GospeMelissa Daluvoy

Abstract

To report the clinical and histopathological findings of a patient with bilateral keratomalacia arising from severe vitamin A deficiency from panic disorder-related malnutrition. Case report. A 47-year-old male with panic disorder presented with 1 month of painful vision loss sequentially affecting the right and left eyes. He exhibited bilateral conjunctival xerosis with complete corneal melt in the right eye and a large corneal epithelial defect with underlying anterior chamber inflammation in the left eye. Laboratory investigation revealed undetectable serum vitamin A levels attributed to self-induced vomiting and starvation. He was treated with high-dose vitamin A, but the right eye required enucleation. The histological findings are reported. Vitamin A deficiency in the absence of organic gastrointestinal abnormalities is exceedingly rare in the developed world. A strong index of suspicion and thorough review of systems are invaluable in evaluating patients with unexplained corneal melt.

References

Mar 1, 1990·Archives of Ophthalmology·E P SuanP R Laibson
Nov 7, 2000·International Ophthalmology Clinics·J Smith, T L Steinemann
Aug 28, 2007·Cornea·Theresa M CooneyVictor M Elner
Apr 22, 2015·Survey of Ophthalmology·Chameen SamarawickramaStephanie Watson

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Citations

Jun 11, 2020·International Journal of Retina and Vitreous·Meghan K BerkenstockAndrew R Carey

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