A Premature Infant with Bilateral Corneal Ulceration due to Vitamin A Deficiency

Abstract

A premature newborn with a gestational age of 25 weeks and a birth weight of 750 grams was presented with bilateral corneal epithelial ulcers at 39 weeks (of corrected gestational age). The patient developed the ulcers one week after the laser treatment for retinopathy of prematurity, which was performed at 35 weeks of corrected gestational age. Topical antibiotics and artificial tears were administered as an initial tretment. However, both ulcers were inresponsive to the treatment. Peripheral blood was drawn for the evaluation of serum vitamin A level, and the patient was treated with topical and systemic vitamin A. The epithelial ulcers healed within two weeks; however, bilateral superficial corneal haze persisted. The initial level of vitamin A was observed to be low in the serum. At the end of the first year, corneal haze  regressed partially in both eyes. It should be noted that vitamin A deficiency can be presented with a variety of clinical signs and in unusual patients with current medical and nutritional practices. Furthermore, vitamin A deficiency should be considered in the differential diagnosis of corneal diseases in the various age groups.