OFTALMOLOGÍA — OPHTHALMOLOGY
Common deficiencies The most common deficiencies are: iron, folic acid and vitamin B12. The diets of these patients are often supplemented with iron and vitamins. However, the largely forgotten ones are the fat soluble vitamins: A, E, D and K. Their deficiencies are much less common, so we don’t see them as often in the clinic. Vitamin A (retinol) is essential for the photoreceptor in the retina to make the light-absorbing pigments. A vitamin A deficiency causes nyctalopia—night blindness—,the most common symptom. In fact, in Ancient Egypt it was discovered that the disorder improved through dietary management using liver (rich in vitamin A). A vitamin A deficiency also affects the eye’s surface. Retinol leads to cell differentiation, and may result in various disorders of the eye: conjunctival and corneal dryness, and keratomalacia.
Increasingly more patients are receiving surgical treatment for obesity (bariatric surgery). This treatment has potential adverse effects
(minimiza los trastornos de “desgaste” del metabolismo del cuerpo) puede causar trastornos neuromusculares: ataxia, hiporreflexia, pérdida de sensibilidad, oftalmoplejía (parálisis de la movilidad ocular) y retinopatía. La prevención es la clave en estos pacientes en los que provocamos una “malabsorción adquirida” para curar su obesidad. Con los suplementos de estos micronutrientes, y alertas de las revisiones oftalmológicas pertinentes, podremos prevenir, y si es preciso diagnosticar y curar, los trastornos derivados de la deficiente nutrición. • 48 NÚM. 34 • AÑO 2019 • BARRAQUER
A vitamin E deficiency (tocopherol), which functions as an anti-oxidant (it minimises “burnout” of the body’s metabolism), may cause neuromuscular disorders: ataxia, hyporeflexia, loss of sensitivity, ophthalmoparesis (ocular movement paralysis) and retinopathy. Prevention is key for those patients in whom we induce temporary malabsorption to treat their obesity. With the supplements of these micronutrients, and timely eye check-up reminders, we can prevent, and where appropriate, diagnose and cure, disorders derived from poor nutrition. •