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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)
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.
Night blindness and its worsened condition, xerophthalmia, are markers of Vitamin A deficiency; collections of keratin in the conjunctiva, known as Bitot's spots, and ulceration and necrosis of cornea keratomalacia can be seen. Conjunctival epithelial defects occur around lateral aspect of the limbus in the subclinical stage of VAD.
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.
Bitot's spots: Pierre Alain Bitôt (22 March 1822, in Podensac – 2 February 1888) was a French physician, anatomist and surgeon; remembered for describing Bitot's ...
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