Wernicke encephalopathy and optic neuropathy from thiamine deficiency after sleeve gastrectomy. Case report

Objective: Present to the ophthalmologist the serious consequences of thiamine deficiency after a sleeve gastrectomy.Case report: A 28-year-old Colombian woman referred for bilateral papillary pallor with a history of bariatric surgery (sleeve gastrectomy) 9 months before consulting.Two months after surgery, she began to vomit intensely and developed a neurological condition that was diagnosed as Wernicke's encephalopathy.In the ophthalmological examination, she presented oculomotor sequelae of her Wernicke's and nutritional optic neuropathy due to thiamine deficiency.Excessive vomiting accompanied by malnutrition is a risk factor for the development of vitamin deficiency, also taking into account the recent bariatric surgery.The treatment is based on the rapid administration of parenteral thiamine without waiting to confirm the diagnosis.Conclusions: It is necessary to maintain a high index of suspicion to make the diagnosis in these cases, because the appearance of serious sequelae, even death, are possible.