Bilateral corneal ulcers in primary vitamin A deficiency

Purpose. 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 mu g/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.