Australian woman with Vitamin A deficiency suffers fungal keratitis

BMJ Case Reports authors have described their treatment of a patient who suffered vision loss after becoming malnourished

vegetable box

A woman in her 60s who presented to a Melbourne hospital with corneal perforations was found to be suffering from Vitamin A deficiency.

The patient, whose case was described in BMJ Case Reports, presented with visual acuity of 6/180 in her left eye, while it was limited to perception of hand movements in her right eye.

Screening for autoimmune disease and infection was negative, while a left corneal scrape revealed light mixed organisms and a yeast colony.

The case report authors highlighted that the patient was found to be experiencing Vitamin A deficiency.

“This deficiency was likely due to a severely restricted diet, consisting of only bananas and yoghurt. The final diagnosis was corneal perforations secondary to bilateral fungal keratitis and hypovitaminosis,” the authors shared.

The patient required tectonic corneal grafts to treat the perforations. She received oral and topical voriconazole to treat bilateral fungal keratitis, and retinyl palmitate to address her Vitamin A deficiency.

While the patient’s visual acuity improved over time, her diet continued to be limited and there were issues with non-compliance with the treatment regime.

Her final visual acuity was limited to hand movements in the right eye and 6/30 in the left eye.