title: Adult blindness secondary to vitamin A deficiency associated with an eating disorder.
abstract: OBJECTIVE
  We examined an adult patient who lost one eye due to severe keratomalacia secondary to self-induced vitamin A deficiency.
  
  
  METHODS
  This case report provides a clinical, ophthalmologic, and laboratory description in addition to a review of the medical literature.
  
  
  RESULTS
  A 33-y-old woman with a 17-y history of an eating disorder presented with bilateral conjunctival xerosis, an infected corneal ulcer in the right eye and a large descemetocele in the left eye. Laboratory and clinical findings were consistent with vitamin A deficiency. Despite a tectonic penetrating keratoplasty, her left eye perforated and had to be eviscerated. In parallel, vitamin A replacement improved her clinical status and the ocular findings in her right eye.
  
  
  CONCLUSIONS
  The present report indicates that vitamin A deficiency secondary to eating disorders should be considered in the differential diagnosis of patients with severe dry eye and corneal ulceration.
authors.affiliation: Department of Ophthalmology, Division of Nutriology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
authors.forename: Antonio Augusto
authors.initials: AA
authors.lastname: Velasco Cruz
authors.forename: Flávia A
authors.initials: FA
authors.lastname: Attié-Castro
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Fernandes
authors.forename: Jussara Fialho F
authors.initials: JF
authors.lastname: Cortes
authors.forename: Paulo
authors.initials: P
authors.lastname: de Tarso P Pierre-Filho
authors.forename: Eduardo Melani
authors.initials: EM
authors.lastname: Rocha
authors.forename: Júlio Sérgio
authors.initials: JS
authors.lastname: Marchini
mesh_terms: D000328:Adult; D001766:Blindness / Q000209:etiology*; D003229:Conjunctival Diseases / Q000175:diagnosis / Q000209:etiology; D003320:Corneal Ulcer / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D017234:Eye Evisceration; D001068:Feeding and Eating Disorders / Q000150:complications*; D005260:Female; D006801:Humans; D016896:Treatment Outcome; D014801:Vitamin A / Q000627:therapeutic use*; D014802:Vitamin A Deficiency / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014985:Xerophthalmia / Q000175:diagnosis / Q000209:etiology
chemical_list: D014801:Vitamin A