title: Bilateral corneal ulcers in primary vitamin A deficiency.
abstract: OBJECTIVE
  To report a case of bilateral corneal ulcers and perforations resulting from hypovitaminosis A in an alcoholic patient.
  
  
  METHODS
  A 38-year-old cachetic man presented with bilateral corneal ulcerations and severe visual loss. He was hospitalized, developed bilateral corneal perforations, and was treated with bilateral corneal transplants.
  
  
  RESULTS
  Serum vitamin A level was 0.01 microg/dL (normal, 0.30-0.75). The electroretinogram was consistent with vitamin A deficiency. His clinical status improved after vitamin A replacement.
  
  
  CONCLUSIONS
  Although rare in developed countries, the ophthalmologist must consider avitaminosis A in the differential diagnosis of corneal ulcerations in cachetic, alcoholic, or chronically ill patients. Early diagnosis and treatment can prevent unwanted outcomes.
authors.affiliation: Department of Ophthalmology, West Virginia University School of Medicine, Morgantown 26506, USA.
authors.forename: M S
authors.initials: MS
authors.lastname: Macsai
authors.forename: S
authors.initials: S
authors.lastname: Agarwal
authors.forename: E
authors.initials: E
authors.lastname: Gamponia
mesh_terms: D000328:Adult; D003320:Corneal Ulcer / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D004596:Electroretinography; D006801:Humans; D015948:Keratoplasty, Penetrating; D008297:Male; D012422:Rupture, Spontaneous; D014801:Vitamin A / Q000097:blood / Q000627:therapeutic use; D014802:Vitamin A Deficiency / Q000097:blood / Q000150:complications* / Q000628:therapy; D014985:Xerophthalmia / Q000209:etiology* / Q000473:pathology / Q000601:surgery
chemical_list: D014801:Vitamin A