Keratomalacia in a Patient With Psychogenic Vitamin A Deficiency.
PURPOSE: To report the clinical and histopathological findings of a patient with bilateral keratomalacia arising from severe vitamin A deficiency from panic disorder-related malnutrition.
METHODS: Case report.
RESULTS: 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.
CONCLUSIONS: 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.
Published In/Presented At
Gospe, S. M., 3rd, Todorich, B., Foster, Y. G., Legault, G., Woods, S. K., Proia, A. D., & Daluvoy, M. (2016). Keratomalacia in a Patient With Psychogenic Vitamin A Deficiency. Cornea, 35(3), 405–407. https://doi.org/10.1097/ICO.0000000000000732
Medicine and Health Sciences
Department of Medicine