Purpose: Vitamin A deficiency (VAD) is well known as a sight and life threatening disorder in developing nations however VAD is rare in developed nations. VAD presents with xerosis conjunctivae, night blindness and systemic infections. Cases reported of VAD in children in developed countries are primarily due to a restricted diet and thus, avoidable. This case report aims to raise awareness of VAD in Aotearoa.
Methods: A case report from the Blind and Low Vision Education Network New Zealand (BLENNZ)
Results: A 16 year old Caucasian male presented to BLENNZ with an undiagnosed cause of vision loss. Vision which was previously 6/6 right eye and 6/12 left eye had decreased to hand movements. He had a history of recurrent respiratory, urinary and skin infections, Bell’s palsies, and severe aversion to food with multiple food allergies. On examination xerosis conjunctivae, Bitot’s spots and bilateral optic nerve atrophy were present. A diagnosis of VAD was confirmed by blood test (Vitamin A <0.1µmol/L).
Conclusions: VAD can occur in the developed world resulting in severe systemic illness and blindness. Systemic risks and risk of potential visual loss associated with food aversion, or diet restriction in younger children must be addressed appropriately before serious long term health consequences occur.