Ocular manifestations and impression cytology of anorexia nervosa.
A prospective age- and sex-controlled study of seven anorexia nervosa patients and seven normal control patients was conducted to determine the ocular manifestations of anorexia nervosa. Slit-lamp examination of the anorexic patients demonstrated a high incidence (4/7) of multiple episcleral capillary aneurysms and subconjunctival hemorrhages. Two of seven anorexia nervosa patients had bilateral superficial punctate keratopathy. Anesthetized Schirmer tear testing demonstrated a significantly (P less than 0.005) reduced mean tear production in the anorexia nervosa group (11.3 mm) compared with the control group (22.4 mm). Masked interpretation of conjunctival impression cytology demonstrated moderate to severe conjunctival squamous metaplasia in the majority of the anorexia nervosa group (5/7) compared to normal conjunctival epithelium in the majority of the control group (5/7). Absence of nyctalopia, Bitot's spots, and xerosis, and lack of conjunctival goblet cell loss indicate that the anorexia nervosa group did not have vitamin A deficiency.
Department of Ophthalmology, Tufts-New England Medical Center, Boston.
J M
JM
Gilbert
J S
JS
Weiss
A L
AL
Sattler
J M
JM
Koch
D000328:Adult; D000783:Aneurysm / Q000209:etiology; D000856:Anorexia Nervosa / Q000150:complications*; D001824:Body Constitution; D003118:Color Perception; D003229:Conjunctival Diseases / Q000209:etiology / Q000473:pathology; D003316:Corneal Diseases / Q000209:etiology; D005128:Eye Diseases / Q000209:etiology* / Q000473:pathology; D005260:Female; D006470:Hemorrhage / Q000209:etiology; D006801:Humans; D011446:Prospective Studies; D012590:Sclera / Q000098:blood supply; D013666:Tears / Q000378:metabolism; D014792:Visual Acuity