Bilateral corneal ulcers in primary vitamin A deficiency

Cornea. 1998 Mar;17(2):227-9. doi: 10.1097/00003226-199803000-00020.


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 microg/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.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Corneal Ulcer / etiology*
  • Corneal Ulcer / pathology
  • Corneal Ulcer / surgery
  • Electroretinography
  • Humans
  • Keratoplasty, Penetrating
  • Male
  • Rupture, Spontaneous
  • Vitamin A / blood
  • Vitamin A / therapeutic use
  • Vitamin A Deficiency / blood
  • Vitamin A Deficiency / complications*
  • Vitamin A Deficiency / therapy
  • Xerophthalmia / etiology*
  • Xerophthalmia / pathology
  • Xerophthalmia / surgery


  • Vitamin A