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Bitot’s Spots 

Classic Bitot's spot in a 29-year-old man that shrunk dramatically with vitamin A therapy. (Sommer A: Nutritional Blindness: Xerophthalmia and Keratomalacia. New York, Oxford University Press, 1982) [5]

Classic Bitot’s spot in a 29-year-old man that shrunk dramatically with vitamin A [6] 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 [6] deficiency.

This painless eye disorder is reversible only with vitamin A [6] 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 [7]

Bitot’s spots may develop in malnutrition, reduced intake including alcoholism, medication adverse effect, old age, low stomach acid, and disease causing vitamin A [6] deficiency such as celiac disease, Crohn’s disease, pancreatic insufficiency, and short bowel syndrome.  Other conditions associated with vitamin A [6] 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 [6] deficiency. Klinische Monatsblatter fur Augenheilkunde. Aug 1994;205(2)76-85.  [10]