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Keratitis in hypo- and avitaminosis
Last reviewed: 07.07.2025
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Keratitis in hypo- and avitaminosis is caused by a violation of general metabolic processes in the body. They occur due to the intake of insufficient amounts of vitamins or poor absorption of individual groups of vitamins. Corneal damage is most often observed with a deficiency of vitamins A, B, B2, C, PP, E. Corneal diseases develop against the background of severe general pathology of the body, which is a consequence of vitamin deficiency or, conversely, complicates the absorption of vitamins. Usually both eyes are affected. The severity of changes in the cornea depends on the degree of vitamin deficiency in the body with hypovitaminosis, and in extremely severe cases (avitaminosis) - on the duration of the disease and the content of other vitamins.
[ Symptoms and treatment of keratitis in hypo- and avitaminosis
The most effective method of primary diagnosis is to determine the symptoms of the disease.
Keratitis due to vitamin A deficiency
Avitaminosis A causes changes in the epithelial layer of the conjunctiva and cornea. Avitaminosis has the following symptoms: - at the initial stage, the sensitivity of the cornea decreases and dystrophic changes slowly increase, the normal shine and moisture of the surface disappear. It becomes dull, cloud-like opacities appear. This is the prexerosis stage, which is replaced by epithelial xerosis, i.e. keratinization of the epithelium. At first, xerotic dry plaques appear on the conjunctiva of the eyeball and cornea within the open eye slit, similar to small drops of solidified fat. The superficial dry cells exfoliate, causing discomfort. At this stage, with rational nutrition and treatment, recovery is still possible with a slight loss of eye function. The third stage of avitaminosis A is keratomalacia. The entire cornea becomes cloudy. The changes quickly move from the superficial layers to the deep ones. Simultaneously with the spread of opacity, the process of corneal disintegration begins. There is abundant discharge in the corners of the eyes. Treatment started at this stage ends with rough scarring of the defects. Without treatment, corneal perforation occurs. Due to the lack of sensitivity of the cornea, tissue disintegration occurs painlessly.
Treatment: a balanced diet including animal and plant products rich in vitamins A and carotene, an oil solution of retinol acetate orally or intramuscularly at a daily dose of 100,000 IU and a multivitamin complex.
Locally: instillation of sulfanilamide preparations 3-4 times a day to prevent infection of the eroded surface; vitamin drops (citral and riboflavin in alternation), preparations that promote epithelial regeneration (retinol, actovegin, balarpan, fish oil); in addition, ointments containing vitamins are mandatory.
Keratitis due to vitamin B deficiency
Avitaminosis B, in the cornea manifests itself against the background of general changes in the body, symptoms of avitaminosis: polyneuritis, loss of muscle tone, dysfunction of the gastrointestinal tract. Opacities occur in the central part of the cornea, edema of the epithelium, then discoid keratitis develops with a persistent long-term course and a severe outcome. The superficial layers of the cornea become infected, necrotic, and may be perforated. Already at the stage of development of discoid keratitis, the iris and ciliary body are involved in the pathological process, and then the choroid.
Treatment: rational nutrition with the inclusion of dishes from legumes, cereals, liver, kidneys. Thiamine bromide and multivitamins are prescribed in therapeutic doses.
Local treatment depends on the stage of the disease. The general approach is the same as for vitamin A deficiency.
Keratitis due to vitamin deficiency B 2
Avitaminosis B 2 can cause superficial keratitis with ulceration, but a stromal form of inflammation is also possible. Keratitis with avitaminosis B 2 is characterized by the ingrowth of a large number of superficial vessels. Rational treatment at the stage of early manifestations leads to recovery. Corneal disease, this avitaminosis symptoms occur against the background of seborrheic dermatitis, angular stomatitis, glossitis and other manifestations of avitaminosis B 2.
Treatment: proper nutrition with mandatory daily inclusion of milk, meat, legumes in the diet; riboflavin preparations and multivitamins are prescribed in therapeutic doses according to age.
Local treatment is symptomatic. A 0.02% solution of riboflavin in drops is used. The general principle of local treatment is the same as for vitamin A deficiency. To suppress the growth of newly formed vessels, subconjunctival injections of steroid drugs (dexazone 0.5 ml once a day) are administered in courses of 7-10 days.
Keratitis due to vitamin deficiencies B6 , B12 , PP, E
Avitaminosis B6 , B12 , PP, E always affects the condition of the cornea, manifests itself in a violation of epithelialization, mainly in the central section, after which the cornea is saturated with tear fluid, its transparency changes, infiltrates appear, then erosions and ulcers. Newly formed vessels grow at different times. Keratitis occurs against the background of general changes in the body, characteristic of a given hypo- or avitaminosis. It is the identification of a connection with a specific general pathology that allows us to establish the correct diagnosis and prescribe general etiological treatment, without which local therapy is ineffective.
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