Vitamin A deficiency leading to xerophthalmia and corneal ulcer in a preterm infant with retinopathy of prematurity

We present a case of a 2-month-old preterm female infant, born at 30 weeks of gestation, who developed retinopathy of prematurity (ROP) and subsequently presented with xerophthalmia and a corneal ulcer due to severe vitamin A deficiency. The infant received high-dose vitamin A supplementation (100,000 IU) alongside topical antibiotics and lubricants; steroids were also administered, though their use is controversial. Within one week, conjunctival health improved significantly, and the corneal ulcer healed. This case highlights the critical role of vitamin A in ocular health among preterm infants with ROP, the influence of maternal nutrition on infant vitamin A stores, and the need for vigilant monitoring to prevent severe complications. It also underscores that while corneal ulcers in vitamin A deficiency are typically bilateral, unilateral presentation can occur.