Bitot's spots
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| name = Bitot's spots
| image = Bitot_spot_svg_hariadhi.svg|
| caption = Bitot's spot|
| image2 =Typical location of Bitot's spots.jpg
| caption2 = Typical location of Bitot's spots
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Bitot's spots are the buildup of keratin located superficially in the conjunctiva of human's eyes. They can be oval, triangular or irregular in shape. The spots are a sign of vitamin A deficiency and associated with drying of the cornea. In 1863, the French physician Pierre Bitot (1822–1888) first described these spots.{{cite journal|last1=Shukla|first1=M|last2=Behari|first2=K|title=Congenital Bitot spots.|journal=Indian Journal of Ophthalmology|date=Jul 1979|volume=27|issue=2|pages=63–4|pmid=541036|url=http://www.ijo.in/article.asp?issn=0301-4738;year=1979;volume=27;issue=2;spage=63;epage=64;aulast=Shukla}}
The spots may abate under replacement therapy.{{Cite journal |doi = 10.1056/NEJMicm1715354|pmid = 30157394|title = Bitot's Spots|journal = New England Journal of Medicine|volume = 379|issue = 9|pages = 869|year = 2018|last1 = Ram|first1 = Jagat|last2 = Jinagal|first2 = Jitender|s2cid = 52126826}}
In ancient Egypt, this was treated with animal liver, which is where vitamin A is stored.{{cite book|last=Numitor|first=Gerd|title=Bitot's Spots|url=https://books.google.com/books?id=3yq6tgAACAAJ|date=February 2012|publisher=Flu Press|isbn=978-620-0-57824-2}}
Causes
A major cause of Bitot's spots is vitamin A deficiency (VAD).{{cite journal |last1=Gilbert |first1=Clare |title=The eye signs of vitamin A deficiency |journal=Community Eye Health |date=2013 |volume=26 |issue=84 |pages=66–67 |pmid=24782581 |pmc=3936686 |issn=0953-6833}} Rarely, pellagra due to deficiency of vitamin B3 (niacin) may also cause Bitot's spots.{{cite journal |last1=Levine |first1=Robert A. |last2=Rabb |first2=Maurice F. |title=Bitot's Spot Overlying a Pinguecula |url=https://jamanetwork.com/journals/jamaophthalmology/article-abstract/630394 |journal=Archives of Ophthalmology |pages=525–528 |language=en |doi=10.1001/archopht.1971.01000010527007 |date=1 November 1971|volume=86 |issue=5 |pmid=5315641 |url-access=subscription }} 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)
Treatment
VAD is commonly treated with oral vitamin A supplements.{{cite web |title=Vitamin A Deficiency Treatment & Management: Medical Care, Consultations, Diet |url=https://emedicine.medscape.com/article/126004-treatment#:~:text=Treatment%20for%20subclinical%20VAD%20includes,%2D%20600%20mcg%20(2000%20IU) |date=9 November 2019}} Improvement of Bitot's spots is seen with high-dose vitamin A therapy.{{cite web |title=Management of Bitot's Spots |url=https://www.aao.org/eyenet/article/management-of-bitot-s-spots |website=American Academy of Ophthalmology |language=en |date=1 December 2016}} Bitot's spots non-responsive to vitamin A therapy may be removed surgically.{{cite web |last1=Themes |first1=U. F. O. |title=Bitot's Spots |url=https://entokey.com/bitots-spots/#:~:text=For%20patients%20who%20are%20nonresponsive,remove%20these%20unsightly%20conjunctival%20spots. |website=Ento Key |date=11 September 2016}}
References
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External links
{{Medical resources
| ICD9 = {{ICD9|264.1}}
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{{Nutritional pathology}}
{{Eponymous medical signs for eyes and ears}}
{{DEFAULTSORT:Bitot's Spots}}
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