A patient with a severe deficiency in one or more essential nutrients can develop an optic neuropathy with loss of vision. Although reversible if caught early, it can lead to permanent blindness.

Risk factors:

(1) starvation

(2) highly-restricted diet (junk food only, other)

(3) status post bariatric surgery


Nutritional deficiencies may include:

(1) folate

(2) vitamin B12

(3) other B vitamins (B1, B6)

(4) vitamin E

(5) copper


Clinical features:

(1) papillomacular bundle damage

(2) central scotoma

(3) reduction in color vision


Differential diagnosis:

(1) tobacco-alcohol optic neuropathy

(2) hereditary optic neuropathy

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