A 46-year-old male presented with a 5-yr history of nyctalopia. Best-corrected visual acuity was 20/25 in the right eye and 20/40 in the left eye. The patient had undergone Roux-en-Y gastric bypass surgery 13 yr earlier and reported irregular vitamin A supplementation. Ophthalmic examination revealed bilateral Bitot spots (Figure 1 A, B) and retinal findings resembling fundus albipunctatus (Figure1 C, D). This case highlights the importance of long-term ophthalmologic follow-up in patients undergoing malabsorptive bariatric surgery, as late-onset ocular manifestations of vitamin A deficiency may occur even years after the procedure^(1,2).

REFERENCES

1. Faustino JF, Ribeiro-Silva A, Dalto RF, Souza MM, Furtado JM, Rocha GM, et al. Vitamin A and the eye: an old tale for modern times. Arq Bras Oftalmol. 2016;79(1):56–61.

2. Levine DA, Mathew NE, Jung EH, Yan J, Newman NJ, Thulasi P, et al. Characteristics of vitamin A Deficiency Retinopathy at a Tertiary Referral Center in the United States. Ophthalmol Retina. 2024;8(2):126–36.

Data Availability Statement: The datasets generated and/or analyzed during the current study are already available.

Edited by
Editor-in-Chief: Newton Kara-Júnior

Submitted for publication: January 20, 2026.
Accepted for publication: January 23, 2026.

Funding: This study received no specific financial support.

Disclosure of potential conflicts of interest: The authors declare no potential conflicts of interest.