A Case of Keratomalacia in Severe Vitamin A Deficiency

Vitamin A is a lipid-soluble vitamin essential for vision, playing a critical role in the function and health of the retina and cornea. While vitamin A deficiency is a common global health issue, it is relatively rare in the United States, typically occurring in the context of malnutrition or malabsorption syndromes. Xerophthalmia encompasses the spectrum of ocular manifestations associated with vitamin A deficiency, ranging from night blindness to keratomalacia. In this report, we describe a severe case of xerophthalmia manifesting as keratomalacia in a 42-year-old woman with short bowel syndrome. She presented with five weeks of progressive right eye pain, redness, and vision loss and further evaluation revealed undetectable vitamin A levels, attributed to malabsorption. This case highlights the critical importance of considering vitamin A deficiency in patients with corneal pathology and risk factors for malabsorption. Early diagnosis and treatment are crucial to prevent irreversible vision loss.