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A major cause of Bitot's spots is vitamin A deficiency (VAD). [4] Rarely, pellagra due to deficiency of vitamin B 3 (niacin) may also cause Bitot's spots. [5] They can also be caused by Colestyramine , which is a bile acid sequestrant which can reduce the absorption of fat soluble vitamins (Vitamins A, D, E, K)
Initial assessment may be made based on clinical signs of VAD. [22] The most common sign of VAD is night blindness, but VAD might also present with conjunctival xerosis, Bitot spots (foamy lesions), corneal xerosis, or corneal ulcerations. [23] A VAD deficiency diagnosis is confirmed with laboratory findings.
The condition is not congenital and develops over the course of a few months as the lacrimal glands fail to produce tears. Other conditions involved in the progression already stated include the appearance of Bitot's spots, which are clumps of keratin debris that build up inside the conjunctiva and night blindness, which precedes corneal ulceration and total blindness.
Typical location of Bitot's spots. Xerophthalmia, caused by a severe vitamin A deficiency, is described by pathologic dryness of the conjunctival epithelium and cornea. The conjunctiva becomes dry, thick, and wrinkled. Indicative is the appearance of Bitot's spots, which are clumps of keratin debris that build up inside the conjunctiva.
Signs and symptoms are also applied to physiological states outside the context of disease, as for example when referring to the signs and symptoms of pregnancy, or the symptoms of dehydration. Sometimes a disease may be present without showing any signs or symptoms when it is known as being asymptomatic . [ 13 ]
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