Infrared Photography: A Novel Diagnostic Approach for Ocular Surface Abnormalities Due to Vitamin A Deficiency

Vitamin A deficiency (VAD) remains a significant cause of preventable blindness worldwide, with ocular surface changes representing early manifestations that require prompt recognition and treatment. Conventional examination methods are capable of detecting advanced changes; however, subtle conjunct...

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Main Authors: Hideki Fukuoka, Chie Sotozono
Format: Article
Language:English
Published: MDPI AG 2025-07-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/15/1910
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author Hideki Fukuoka
Chie Sotozono
author_facet Hideki Fukuoka
Chie Sotozono
author_sort Hideki Fukuoka
collection DOAJ
description Vitamin A deficiency (VAD) remains a significant cause of preventable blindness worldwide, with ocular surface changes representing early manifestations that require prompt recognition and treatment. Conventional examination methods are capable of detecting advanced changes; however, subtle conjunctival abnormalities may be overlooked, potentially delaying the administration of appropriate interventions. We herein present the case of a 5-year-old Japanese boy with severe VAD due to selective eating patterns. This case demonstrates the utility of infrared photography as a novel diagnostic approach for detecting and monitoring conjunctival surface abnormalities. The patient exhibited symptoms including corneal ulcers, night blindness, and reduced visual acuity. Furthermore, blood tests revealed undetectable levels of vitamin A (5 IU/dL), despite relatively normal physical growth parameters. Conventional slit-lamp examination revealed characteristic sandpaper-like conjunctival changes. However, infrared photography (700–900 nm wavelength) revealed distinct abnormal patterns of conjunctival surface folds and keratinization that were not fully appreciated on a routine examination. Following high-dose vitamin A supplementation (4000 IU/day), complete resolution of ocular abnormalities was achieved within 2 months, with infrared imaging objectively documenting treatment response and normalization of conjunctival surface patterns. This case underscores the potential for severe VAD in developed countries, particularly in the context of dietary restrictions, thereby underscoring the significance of a comprehensive dietary history and a meticulous ocular examination. Infrared photography provides a number of advantages, including the capacity for non-invasive assessment, enhanced visualization of subtle changes, objective monitoring of treatment response, and cost-effectiveness due to the use of readily available equipment. This technique represents an underutilized diagnostic modality with particular promise for screening programs and clinical monitoring of VAD-related ocular manifestations, potentially preventing irreversible visual loss through early detection and intervention.
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spelling doaj-art-b8fb78baaf1a4a8089a47ec2bc0ebf112025-08-20T03:02:48ZengMDPI AGDiagnostics2075-44182025-07-011515191010.3390/diagnostics15151910Infrared Photography: A Novel Diagnostic Approach for Ocular Surface Abnormalities Due to Vitamin A DeficiencyHideki Fukuoka0Chie Sotozono1Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanDepartment of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto 602-8566, JapanVitamin A deficiency (VAD) remains a significant cause of preventable blindness worldwide, with ocular surface changes representing early manifestations that require prompt recognition and treatment. Conventional examination methods are capable of detecting advanced changes; however, subtle conjunctival abnormalities may be overlooked, potentially delaying the administration of appropriate interventions. We herein present the case of a 5-year-old Japanese boy with severe VAD due to selective eating patterns. This case demonstrates the utility of infrared photography as a novel diagnostic approach for detecting and monitoring conjunctival surface abnormalities. The patient exhibited symptoms including corneal ulcers, night blindness, and reduced visual acuity. Furthermore, blood tests revealed undetectable levels of vitamin A (5 IU/dL), despite relatively normal physical growth parameters. Conventional slit-lamp examination revealed characteristic sandpaper-like conjunctival changes. However, infrared photography (700–900 nm wavelength) revealed distinct abnormal patterns of conjunctival surface folds and keratinization that were not fully appreciated on a routine examination. Following high-dose vitamin A supplementation (4000 IU/day), complete resolution of ocular abnormalities was achieved within 2 months, with infrared imaging objectively documenting treatment response and normalization of conjunctival surface patterns. This case underscores the potential for severe VAD in developed countries, particularly in the context of dietary restrictions, thereby underscoring the significance of a comprehensive dietary history and a meticulous ocular examination. Infrared photography provides a number of advantages, including the capacity for non-invasive assessment, enhanced visualization of subtle changes, objective monitoring of treatment response, and cost-effectiveness due to the use of readily available equipment. This technique represents an underutilized diagnostic modality with particular promise for screening programs and clinical monitoring of VAD-related ocular manifestations, potentially preventing irreversible visual loss through early detection and intervention.https://www.mdpi.com/2075-4418/15/15/1910vitamin A deficiencyinfrared photographyconjunctival changespediatric nutritionocular surfacediagnostic imaging
spellingShingle Hideki Fukuoka
Chie Sotozono
Infrared Photography: A Novel Diagnostic Approach for Ocular Surface Abnormalities Due to Vitamin A Deficiency
Diagnostics
vitamin A deficiency
infrared photography
conjunctival changes
pediatric nutrition
ocular surface
diagnostic imaging
title Infrared Photography: A Novel Diagnostic Approach for Ocular Surface Abnormalities Due to Vitamin A Deficiency
title_full Infrared Photography: A Novel Diagnostic Approach for Ocular Surface Abnormalities Due to Vitamin A Deficiency
title_fullStr Infrared Photography: A Novel Diagnostic Approach for Ocular Surface Abnormalities Due to Vitamin A Deficiency
title_full_unstemmed Infrared Photography: A Novel Diagnostic Approach for Ocular Surface Abnormalities Due to Vitamin A Deficiency
title_short Infrared Photography: A Novel Diagnostic Approach for Ocular Surface Abnormalities Due to Vitamin A Deficiency
title_sort infrared photography a novel diagnostic approach for ocular surface abnormalities due to vitamin a deficiency
topic vitamin A deficiency
infrared photography
conjunctival changes
pediatric nutrition
ocular surface
diagnostic imaging
url https://www.mdpi.com/2075-4418/15/15/1910
work_keys_str_mv AT hidekifukuoka infraredphotographyanoveldiagnosticapproachforocularsurfaceabnormalitiesduetovitaminadeficiency
AT chiesotozono infraredphotographyanoveldiagnosticapproachforocularsurfaceabnormalitiesduetovitaminadeficiency