Keratomalacia in a Patient With Psychogenic Vitamin A Deficiency.

Journal Article (Journal Article)

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.

Full Text

Duke Authors

Cited Authors

  • Gospe, SM; Todorich, B; Foster, YG; Legault, G; Woods, SK; Proia, AD; Daluvoy, M

Published Date

  • March 2016

Published In

Volume / Issue

  • 35 / 3

Start / End Page

  • 405 - 407

PubMed ID

  • 26785304

Electronic International Standard Serial Number (EISSN)

  • 1536-4798

Digital Object Identifier (DOI)

  • 10.1097/ICO.0000000000000732


  • eng

Conference Location

  • United States