Loss of vision, hearing loss and loss of bone mass caused in a teenager the exclusive consumption of junk food. From the age of 14 when he began to show symptoms of fatigue until the age of 17 his vision gradually decreased and his visual acuity dropped to 1/10 (that is, he saw 1/10 of what a person without vision problems sees), while already at the age of 15 he had neurosensory hearing loss. For five consecutive years, the boy ate fries, chips, ham, sausages and bread and nothing else.
The incident, which happened in Bristol, was presented today by the ophthalmologist – curator at the Athens Naval Hospital, Georgios Karastatirasin the context of the 55th Panhellenic Ophthalmological Conference, organized by the Ophthalmological Society of Northern Greece (May 19-21), in Thessaloniki.
Speaking to APE-MPE, Mr. Karastatiras stated that he himself faced this incident during his specialization at the Ophthalmology Hospital of the University of Bristol and that after a series of examinations he underwent adolescent during three years it was found that the loss of vision was due to his exclusive diet with junk food.
“The child, when he was 14 years old, had symptoms of fatigue. His mother told the GP that the boy was “selective in diet” but was not receiving any systematic treatment. His history was free and he had no problems, no allergies and was normally healthy. Examinations by the general practitioner revealed that he had macrocytic anemia and a lack of vitamin B12. “He was also tested for the endogenous factor, his transaminases were negative and his doctor gave him injectable vitamin B12 and dietary instructions”, said Mr. Karastatiras.
A year later, the child developed neurosensory hearing loss and was referred to ENT. The brain magnetic resonance imaging showed no structural abnormalities. “It was then that he reported that he had some vision symptoms and was referred to the ophthalmologist, who examined him and found his vision normal without any problems. When he reached the age of 17 he reported that he had a very significant loss of vision. The general practitioner sent him to a specialist ophthalmologist and then it was found that his vision was 20/200 (around 1/10 of what a person without vision problems sees) and also had reduced color perception 8/17. He had complete ocular mobility, ocher was normal, the optic nerve showed that he had some lesions initially and had a central killing (ie he saw dark spots) in the visual fields. THE neurological examination it was normal. It was decided to carry out a further investigation with an electro-diagnostic test, which showed bilateral optic neuropathy. The repeated magnetic resonance imaging did not show any other problem and a genetic test was performed for Leber optic neuropathy and no other issue was found. Subsequent further testing was performed and macrocytosis, normal ferritin, folic acid and liver function were found from the general blood. “Examinations showed that he may have been functionally deficient in vitamin B12”, added Mr. Karastatiras.
The child was not overweight, weighed 65 kg and was 1.72 tall, did not use alcohol, tobacco or drugs and his mother told him that he could not eat foods that had some strange textures. “Then we said to look at his diet and we found that for the past five years all he ate was a portion of Fish & Chips french fries, chips, a slice of ham bread and sausages. He ate only these and nothing else. Seeing all this we did a further test, which showed that he had low levels of copper and selenium, high zinc, obviously low vitamin D and also had osteopenia. Digestive biopsies of the digestive system were also found to be normal. We gave him nutritional supplements, referred him to the mental health service and saw that his vision stabilized, but did not improve. “This happened from 2017 until 2020 when I saw him”, said Mr. Karastatiras.
The main causes of optic neuropathy, Mr. Karastatiras cited malabsorption, medication, poor diet, alcoholism, vitamin B deficiency and iron deficiency.
“When we have an unexplained loss of vision we have to put trophic optic neuropathy in our differential diagnosis, especially when the patient follows a poor diet regardless of whether he is obese or not. Eating optic neuropathy is probably reversible if diagnosed early. However, if it remains incurable, it can cause permanent vision loss “, concluded Mr. Karastatiras.
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