Dry conjunctivae

A girl presented with a two-day history of bilateral eye irritation and frequent blinking. Examination revealed dry conjunctivae and whitish, foamy lesions known as Bitot's spots. Visual acuity and retinal appearances were normal. The mother reported that the patient followed a restrictive diet consisting mainly of rice, bread, potato chips, and crisps. Serological tests confirmed vitamin A deficiency (<0.35 µmol/L; reference range 1.05 to 3.84 µmol/L). Xerophthalmia is a spectrum of eye diseases caused by vitamin A deficiency, which can lead to blindness. It typically presents with difficulty seeing in dim lighting conditions, conjunctival dryness, and Bitot's spots. Children with autism spectrum disorder are at higher risk of nutrient deficiencies due to possible restrictive diets.