title: Xerophthalmia and keratomalacia secondary to diet-induced vitamin A deficiency in Scottish adults.
abstract: OBJECTIVE
  To report the ocular features, underlying systemic conditions, and management of diet-induced vitamin A deficiency in Scottish adults.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Three middle-aged white adults presented with ocular signs of xerophthalmia and keratomalacia that led to the diagnosis of previously undiagnosed vitamin A deficiency. Case 1 presented with rapidly progressing bilateral keratomalacia with corneal perforation, whereas Cases 2 and 3 presented with conjunctival and corneal xerosis.
  
  
  RESULTS
  Corneal gluing was performed in Case 1. Cases 2 and 3 were treated topically with preservative-free tears, retinoic acid, and punctual plugs to optimize the ocular surface. This, combined with dietary supplementation, resulted in normalizing the ocular surface.
  
  
  CONCLUSIONS
  Diet-induced vitamin A deficiency can occur in middle-aged white adults. Ocular surface changes may be the presenting sign of hypovitaminosis A in the Western world. A high degree of suspicion with prompt recognition and management of the underlying dietary deficiency can lead to complete reversal of the ocular surface changes.
authors: Department of Ophthalmology, University Hospital Ayr, Ayr.
authors: Ken Lee
authors: KL
authors: Lai
authors: Department of Ophthalmology, University Hospital Ayr, Ayr.
authors: Jia Yu
authors: JY
authors: Ng
authors: Department of Ophthalmology, University Hospital Ayr, Ayr; Faculty of Medicine, University of Glasgow, Glasgow, Scotland, United Kingdom. Electronic address: sathish.srinivasan@gmail.com.
authors: Sathish
authors: S
authors: Srinivasan
mesh_terms: D000328:Adult; D004032:Diet; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014801:Vitamin A / Q000627:therapeutic use; D014802:Vitamin A Deficiency / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D014815:Vitamins / Q000627:therapeutic use; D014985:Xerophthalmia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
chemical_list: D014815:Vitamins; D014801:Vitamin A