title: Vitamin A deficiency in patients with a remote history of intestinal surgery.
abstract: OBJECTIVE
  Vitamin A deficiency, often presenting with nyctalopia, has been described in a number of patients with malabsorption as a result of intestinal bypass surgery and, more recently, bariatric surgery. In these reports vitamin A deficiency developed within several years of gastric or intestinal surgery. Three patients who developed decreased vision from vitamin A deficiency more than 18 years after their intestinal surgery are reported.
  
  
  METHODS
  A retrospective review of the clinical findings of all patients diagnosed with vitamin A deficiency, as confirmed by serological testing, over the past year in a single neuro-ophthalmic practice.
  
  
  RESULTS
  Four patients with vitamin A deficiency were seen, three of whom had intestinal surgery more than 18 years before the development of visual symptoms.
  
  
  CONCLUSIONS
  The authors suggest that vitamin A deficiency should be suspected in patients with unexplained decreased vision and a history of intestinal surgery, regardless of the timing of the surgical procedure.
authors.affiliation: Cullen Eye Institute, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: T
authors.initials: T
authors.lastname: Chae
authors.forename: R
authors.initials: R
authors.lastname: Foroozan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000601:surgery; D007581:Jejunoileal Bypass / Q000009:adverse effects*; D008297:Male; D012189:Retrospective Studies; D012778:Short Bowel Syndrome / Q000150:complications*; D013997:Time Factors; D014786:Vision Disorders / Q000209:etiology; D014802:Vitamin A Deficiency / Q000209:etiology*