An 11-year old boy’s vision was corrupted due to a highly restrictive diet. Doctors in Canada say rare changes to his eyes were caused by a diet limited to potatoes, pork, lamb, apples, cucumbers and Cheerios, none of which is a good source of vitamin A.
The boy’s parents reportedly took him to the hospital, after they noted eight months of progressively worsening vision. Doctors found his vision was severely impaired, and, in some instances, limited to within 12 inches of his face.
Senior author of the case report, Dr. Eyal Cohen, is the pediatrician at the Hospital for Sick Children in Toronto who treated the boy. Dr. Cohen said the outer layer of the boy’s eyes were severely dry, which can lead to a buildup of material in the cornea, the transparent outer covering of the eye. The condition is known as Bitot’s spots, Dr. Cohen said, reporting in the JAMA Pediatrics journal in a report published Oct. 2.
The report indicates the boy had multiple food allergies and eczema, and due to concerns that certain foods might cause an eczema outbreak, his diet was limited by his parents. When the doctors measured the levels of vitamin A in his blood, they found that he had a vitamin A deficiency.
His blood levels of vitamin A were 14.3 micrograms per deciliter (ug/dL), while the normal range 25.8 to 48.7 ug/dL, according to the report.
By those standards, according to Dr. Cohen, the boy’s deficiency was severe. The proper amount of vitamin A is essential for vision.
“Vitamin A deficiency is very common in poorer parts of the world, where it is a leading cause of blindness,” Cohen said.
In developed countries, a vitamin A deficiency is rare, but not unheard of entirely. Dr. Cohen said, “People who have highly restricted diets like the child in this case report are at higher risk of [vitamin A deficiency] and other nutritional deficiencies.”
To treat the boy, he was given intravenous “mega doses” of vitamin A daily for two days. Six weeks later, the appearance of the boy’s eyes had improved significantly, according to the report. However, the level of visual impairment the boy suffered may not be completely corrected, even by wearing glasses. While vision loss from vitamin A deficiency is reversible, in the boy’s case, some of his vision impairment is likely permanent.
Good sources of vitamin A include carrots, sweet potatoes, leafy green vegetables and fish, according to the report.
According to the Harvard T.H. Chan School of Public Health, vitamin A “stimulates the production and activity of white blood cells, takes part in remodeling bone, helps maintain the health of endothelial cells (those lining the body’s interior surfaces), and regulates cell growth and division.”
The school recommends additional sources of vitamin A:
Many breakfast cereals, juices, dairy products, and other foods are fortified with retinol (also known as preformed vitamin A). Many fruits and vegetables, and some supplements, also contain beta-carotene and other vitamin A precursors, which the body can turn into vitamin A. It’s best to choose a multivitamin supplement that has all or the vast majority of its vitamin A in the form of beta-carotene.
Restrictive diet/vitamin A deficiency severly affected boy’s vision in this case study https://t.co/X4k7SZ6vpY
— Liz Hillman (@lizklimas) October 4, 2017
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