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Vitamin A deficiency in patients with a remote history of intestinal surgery
  1. T Chae,
  2. R Foroozan
  1. Cullen Eye Institute, Baylor College of Medicine, Houston, TX, USA
  1. Correspondence to: Rod Foroozan MD, Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin Street NC-205, Houston, TX 77030, USA; foroozan{at}


Background/aims: Vitamin A deficiency, often presenting with nyctalopia, has been described in a number of patients with malabsorption as a result of intestinal bypass surgery and, more recently, bariatric surgery. In these reports vitamin A deficiency developed within several years of gastric or intestinal surgery. Three patients who developed decreased vision from vitamin A deficiency more than 18 years after their intestinal surgery are reported.

Methods: A retrospective review of the clinical findings of all patients diagnosed with vitamin A deficiency, as confirmed by serological testing, over the past year in a single neuro-ophthalmic practice.

Results: Four patients with vitamin A deficiency were seen, three of whom had intestinal surgery more than 18 years before the development of visual symptoms.

Conclusion: The authors suggest that vitamin A deficiency should be suspected in patients with unexplained decreased vision and a history of intestinal surgery, regardless of the timing of the surgical procedure.

  • vitamin A deficiency
  • nyctalopia
  • intestinal surgery

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  • Competing interests: The authors have no competing interests to report.

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