Bitot’s Spots 

Classic Bitot’s spot in a 29-year-old man that shrunk dramatically with vitamin A therapy.*

What Are Bitot’s Spots?

Bitot’s spots are superficial foamy patches that develop on the exposed bulbar conjunctiva (white of the eye) as a manifestation of advanced vitamin A deficiency.

This painless eye disorder is reversible only with vitamin A therapy. It is named after Charles Bitot, who first described it.

Q: What makes up these foamy alterations of the conjunctiva?

A: Bitot’s spots are composed of epithelial debris (dead surface cells) and secretions.1

Bitot’s spots may develop in malnutrition, reduced intake including alcoholism, medication adverse effect, old age, low stomach acid, and disease causing vitamin A deficiency such as celiac disease, Crohn’s disease, pancreatic insufficiency, and short bowel syndrome.  Other conditions associated with vitamin A deficiency may include disordered transport (Abetalipoprotenemia, a genetic disorder) and reduced liver storage caused by liver disease.

What Are Bitot’s Spots In Celiac Disease and/or Gluten Sensitivity?

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1. Sadowski B, Rohrback JM, Steuhl KP, Weidle EG, Castrillon-Obendorfer WL. Corneal manifestations in Vitamin A deficiency. Klinische Monatsblatter fur Augenheilkunde. Aug 1994;205(2)76-85. [↩]