The Financial: It is well known that obesity has been a health issue in the United States for years. More than one in three adults are obese, and more than one in 20 adults are extremely obese, according to the National Institute of Diabetes and Digestive Kidney Diseases.
But what is not well known is that a common method to treat obesity, bariatric surgery, can lead to a serious vision problem: nyctalopia, or night blindness. This is because the most common side effect of bariatric surgery is malnutrition, including decreased levels of fat-soluble vitamins, particularly vitamin A. Vitamin A is necessary for the formation of rhodopsin, the light-sensitive pigment found in rod cells, critical for seeing at night. In fact, night blindness is often the first sign of a deficiency in vitamin A.
Although the complication is rare, given the high number of procedures performed in the U.S., doctors of optometry should be aware of the problem and how to effectively help patients.
Finding the culprit
Brad Lane, O.D., a member of AOA’s Health Promotions Committee, and John Dovie, O.D., came across such a case when a 59-year-old patient presented with complaints of difficulty driving at night and trouble seeing objects in poorly lit rooms. The man—who had just been released from the hospital because of a bout of pneumonia—had a history of gastric bypass procedure more than two decades earlier.
Based on the findings of an examination, a diagnosis of nyctalopia was made. “For some reason I just had a feeling that malnutrition was the culprit,” says Dr. Lane. “The patient was years post-surgery but was still losing weight.”
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