Ophthalmologic manifestations related to malnutrition stem from low levels of vitamin A, vitamin D, and calcium, which are common in celiac disease patients. These include retinopathy, cataract, dry eye, and pseudotumor cerebri:

Retinopathy: characterized by yellowish to white lesions studded with tiny holes in the peripheral retina. It is typically caused by a deficiency in vitamin A. The vitamin A deficiency can also lead to night blindness (nyctalopia). Typically, visual function improves after one to four months of vitamin A supplementation.

Cataracts: marked by the clouding of the lens of the eye, most cataracts develop slowly over time and cause blurry vision. Cataracts can be caused by a vitamin D deficiency, as a vitamin D deficiency interferes with the absorption of calcium and the resulting hypocalcemia (low blood levels of calcium) contributes to the development of cataracts. In addition, diarrhea common in undiagnosed celiac patients can lead to dehydration. Dehydration can alter the composition of the lens and lead to low levels of calcium in the aqueous humor. This leads to hypocalcemia which can then lead to cataracts.

Pseudotumor cerebri: also known as idiopathic intracranial hypertension is characterized by increased intracranial pressure of unknown cause. It is thought to be caused by nutritional, metabolic, endocrinological or hematological disorders. In particular, it is linked with both vitamin A poisoning and vitamin A deficiency, although the mechanisms by which vitamin A deficiency and poisoning results in increased intracranial pressure is still not fully understood. Vitamin A deficiency is a common manifestation of gluten induced intestinal damage.

Dry eye: just as it sounds, dry eye results in uncomfortably dry eyes and sometimes small spots present on the whites of the eyes called Bitot’s spots. Vitamin A deficiency is often the root cause behind this condition as well, and research has shown it is more common in celiac disease patients.

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*These statements have not been evaluated by the Food and Drug Administration. This video is not intended to diagnose, treat, cure or prevent any disease. It is strictly intended for educational purposes only. Additionally, this information is not intended to replace the advice of your physician. Dr. Osborne is not a medical doctor. He does not treat or diagnose disease. He offers nutritional support to people seeking an alternative from traditional medicine. Dr. Osborne is licensed with the Pastoral Medical Association.