Ocular complications in a patient with history of bariatric surgery

Purpose

This case report aims to highlight the potential for severe ocular complications due to vitamin A deficiency (VAD) following bariatric surgery, emphasizing the importance of long-term nutritional monitoring and compliance. We present a case report of corneal ulceration and ocular surface keratinization occurring eight years post-biliopancreatic diversion with duodenal switch (BPD-DS) and discuss its management in the context of limited access to intramuscular vitamin A therapy.

Observations

VAD can present years after bariatric surgery and cause severe ocular complications. In this case, inconsistent multivitamin intake led to xerophthalmia and progressive vision loss, thus highlighting the importance of long-term adherence to supplementation in patients with a history of bariatric surgery. Due to a nationwide shortage of intramuscular vitamin A at the time, high-dose oral therapy was used. Despite being well tolerated, the condition progressed to the point of requiring surgical intervention. This case highlights the importance of early detection, timely treatment, and long-term nutritional monitoring in bariatric patients to prevent irreversible vision loss.

Conclusions and importance

VAD can present years after bariatric surgery and cause serious ocular risks. While oral supplementation showed potential, it was insufficient to prevent surgical intervention. This case report aims to raise awareness of post-surgical risks to vision and highlight the importance of long-term nutritional monitoring and early diagnosis in patients with a history of bariatric surgery.