Rethinking Vitamin A Deficiency: Its Causes, Ophthalmologic Presentation, and Management Gaps at a New England Tertiary Hospital

: In this high-resource clinical setting, VAD is common in an at-risk population and largely driven by nutrition-related disease states affecting absorption, metabolism, and hepatic storage. Despite clear biochemical deficiency and associated mortality risk, VAD is underrecognized, undertreated, and infrequently linked to ocular evaluation, highlighting a critical gap in nutrition-focused screening, interdisciplinary communication, and proactive vitamin A assessment in medically complex adults.