Smith R S, Farrell T, Bailey T
Surv Ophthalmol. 1975 Nov-Dec;20(3):213-9. doi: 10.1016/0039-6257(75)90004-1.
Xerophthalmia and keratomalacia are public health problems of great magnitude which are usually associated with multiple vitamin and protein deficiencies. The authors report the case of a 27-year-old commune member who subjected herself to a bizarre protein and vitamin deficient diet for many months. This ultimately produced nyctalopia, xerophthalmia and keratomalacia with bilateral corneal perforation. Despite therapy, she remained comatose and expired shortly after admission. Ocular pathological changes included bilateral corneal melting with prolapse of intraocular contents, conjunctival epidermidalization, goblet cell atrophy and thinning of the outer nuclear layer of the retina. It is noted that ocular findings in pure avitaminosis A produced experimentalyy include epithelial atrophy followed by keratinization.
干眼症和角膜软化症是严重的公共卫生问题，通常与多种维生素和蛋白质缺乏有关。作者报告了一名27岁公社社员的病例，她坚持数月食用奇怪的蛋白质和维生素缺乏饮食。这最终导致了夜盲症、干眼症和角膜软化症，并伴有双侧角膜穿孔。尽管进行了治疗，但她仍处于昏迷状态，入院后不久死亡。眼部病理变化包括双侧角膜溶解伴眼内容物脱出、结膜表皮化、杯状细胞萎缩以及视网膜外核层变薄。值得注意的是，实验性单纯维生素A缺乏症的眼部表现包括上皮萎缩，随后发生角化。
