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Intestinal surgery a villain?
  1. W B Lee1,
  2. I R Schwab2
  1. 1Cornea and External Disease Section, Eye Consultants of Atlanta, and Department of Surgical Anatomy and Technique, Emory University School of Medicine, Atlanta, GA, USA
  2. 2Department of Ophthalmology and Vision Science, University of California Davis, 4860 Y Street, Suite 2400, Sacramento, CA 95817, USA
  1. Correspondence to: W Barry Lee MD, Cornea, External Disease and Refractive Surgery Section, Eye Consultants of Atlanta, 95 Collier Road, Suite 3000, Atlanta, GA 30309,USA; lee0003{at}

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You need A vitamin

Vitamin A is an essential fat soluble vitamin that must be obtained solely from diet or vitamin supplementation. Normal vitamin A levels are required for appropriate functioning of our immune system, skin, retina, and ocular surface. Without adequate levels of vitamin A in the body (hypovitaminosis A), serious systemic consequences can occur, including significant ophthalmic complications leading to potential vision loss and ultimate blindness if the deficiency is not recognised and corrected. Hypovitaminosis A remains a major health problem of epidemic proportions worldwide with over 127 million people and 4.4 million preschool children affected. Vitamin A deficiency remains the leading cause of preventable blindness in children with an estimated half a million children rendered blind each year; yet even more alarming is many of those children die of the same disease.1 While the major cause of hypovitaminosis A across the world remains malnutrition, Chae and Foroozan in this issue of BJO (p 955) have astutely reminded us that iatrogenic vitamin A deficiency from surgical alteration of the small intestine, the site where vitamin A absorption occurs, can create any number of ophthalmic findings as seen with a malnourished vitamin A deficient patient.2 This problem has global implications as developed countries, which have typically been spared malnutrition and vitamin A …

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