{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T16:41:44Z","timestamp":1761324104363,"version":"3.44.0"},"reference-count":18,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,4,25]]},"abstract":"<jats:p>A 47-year-old woman presented with a 4-week history of progressive loss of vision, first manifesting as night blindness. Additionally, the patient reported frequent severe episodes of diarrhoea over the past month. Her medical history included end-stage renal failure for which she was currently on haemodialysis after a failed renal transplant, chronic pancreatitis and autonomic diabetes mellitus. Ophthalmological examination revealed severe bilateral corneal xerosis, bilateral Bitot\u2019s spots and inferior ulceration of the right cornea. A diagnosis of xerophthalmia due to vitamin A deficiency was made, most likely due to the presence of small intestinal bacterial overgrowth and the patient\u2019s chronic malabsorptive state. Standard management using oral vitamin A tablets was ineffective, resulting in the patient requiring intravenous supplementation. The extent of visual deterioration on presentation and the difficulties encountered managing the patient resulted in the patient\u2019s vision failing to improve.<\/jats:p>","DOI":"10.1136\/bcr-2017-220024","type":"journal-article","created":{"date-parts":[[2017,5,11]],"date-time":"2017-05-11T08:41:57Z","timestamp":1494492117000},"page":"bcr-2017-220024","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Vitamin A deficiency due to chronic malabsorption: an ophthalmic manifestation of a systemic condition"],"prefix":"10.1136","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0967-7320","authenticated-orcid":false,"given":"James","family":"Cheshire","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Heart of England NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sai","family":"Kolli","sequence":"additional","affiliation":[{"name":"University Hospital Birmingham NHS Foundation Trust, Birmingham, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,5,10]]},"reference":[{"key":"2025082703511310000_2017.may09_1.bcr-2017-220024.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.trstmh.2012.01.004"},{"key":"2025082703511310000_2017.may09_1.bcr-2017-220024.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nut.2004.12.003"},{"key":"2025082703511310000_2017.may09_1.bcr-2017-220024.3","doi-asserted-by":"crossref","first-page":"941","DOI":"10.1007\/s00417-011-1715-8","article-title":"Vitamin A deficiency-related retinopathy after bariatric surgery","volume":"250","author":"De Salvo","year":"2012","journal-title":"Graefes Arch Clin Exp Ophthalmol"},{"key":"2025082703511310000_2017.may09_1.bcr-2017-220024.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.ophtha.2004.12.045"},{"key":"2025082703511310000_2017.may09_1.bcr-2017-220024.5","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2003.029371"},{"key":"2025082703511310000_2017.may09_1.bcr-2017-220024.6","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.optom.2013.01.002","article-title":"Reversible night blindness \u2013 A reminder of the increasing importance of vitamin A deficiency in the developed world","volume":"6","author":"Clifford","year":"2013","journal-title":"J Optom"},{"key":"2025082703511310000_2017.may09_1.bcr-2017-220024.7","doi-asserted-by":"publisher","DOI":"10.1136\/bjo.2006.092502"},{"key":"2025082703511310000_2017.may09_1.bcr-2017-220024.8","doi-asserted-by":"publisher","DOI":"10.1016\/S0014-4835(88)80076-9"},{"key":"2025082703511310000_2017.may09_1.bcr-2017-220024.9","unstructured":"World Health Organization, UNICEF, United Sates Agency for International Development, Helen Keller International, Group IVAC. Control of vitamin A deficiency and xerophthalmia: report of a Joint WHO\/UNICEF\/USAID\/Helen Keller International\/IVACG meeting. Geneva, 1982."},{"key":"2025082703511310000_2017.may09_1.bcr-2017-220024.10","unstructured":"Sommer A . Vitamin A deficiency and its consequences: a field guide to detection and control. 3rd edn. 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