BACKGROUND: Diet induced vitamin A deficiency is less
commonly seen in otherwise healthy adults, due to large store of
vitamin A in the body. Night blindness is the commonest
manifestation of vitamin A deficiency in adults, whereas
Keratomalacia is a rare manifestation.
CASE REPORT: A 27 years old Ethiopian woman came to Jimma
University Department of Ohthalmology with a compliant of
protrusion of the globe content of both eyes within a week, after
having redness and fear of light of both eyes for 2 months. She was
a mother of twins and had low socioeconomic status. On general
examination, she was cachectic with enlarged parotid glands. On
ocular examination, she was bilaterally blind and had dry ocular
surface. There was bilaterally melted cornea with prolapsed uveal
tissue. After several investigations she was diagnosed as bilateral
Keratomalacia (stage X3B) secondary to diet induced vitamin A
deficiency. She was supplemented with vitamin A and other
nutritional supplementation. Topical lubricating drops and
ointments were administered. Finally, conjunctival flap was done to
preserve the globe.
CONCLUSION: Although it is rare, treating physicians should be
aware of the occurrence of Keratomalacia in adults which is
potentially blinding. Early recognition and treatment of vitamin A
deficiency at the stage of night blindness is essential in reducing
blindness caused by Keratomalacia.
KEYWORDS: Keratomalacia, xerophthalmia, vitamin A deficiency,
cornea and supplementation

Published: 2019-05-28