An article written by Berkeley’s Dr. Angela Shahbazian and former resident Dr. Betty Li titled, “Xerophthalmia as the Initial Finding in a Patient with Multiple Vitamin Deficiencies and Alcoholic Cirrhosis: a Case Report,” has been published in Clinical Insights in Eyecare. Dr. Shahbazian is an assistant clinical professor of optometry at the Herbert Wertheim School of Optometry & Vision Science, and Dr. Betty Li is currently working at Walnut Creek Eye Care.
Abstract
Introduction
Vitamin A deficiency is uncommon in developed countries but can be recognized clinically in patients who develop signs and symptoms of xerophthalmia. This case report presents a patient with signs and symptoms of xerophthalmia who was found to have multiple vitamin deficiencies due to alcoholic liver cirrhosis.
Case Report
A 53-year-old woman presented to the clinic with symptoms of severe dry eye. Conjunctival lesions consistent with Bitot spots were noted, prompting testing for serum levels of vitamin A and several other vitamins. The patient was ultimately found to have multiple vitamin deficiencies secondary to alcoholic liver cirrhosis. Supportive care and vitamin supplementation resolved the patient’s nutritional deficiencies and improved her ocular and systemic health.
Conclusion
Many diseases that cause vitamin A deficiency can also cause other vitamin deficiencies. Therefore, signs and symptoms of xerophthalmia should prompt testing for vitamin A in addition to several other vitamins, including vitamins B1, B12, and folate. Patients also need testing for ocular manifestations of these vitamin deficiencies, including oculomotor deficiencies and nutritional optic neuropathy. Timely diagnosis, testing, and intervention can help these patients obtain better health outcomes.