Keratomalacia: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Keratomalacia?
An ophthalmologist, a medical doctor who treats eye diseases, usually treats keratomalacia. A pediatrician or primary care doctor often finds the vitamin A problem behind it. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is keratomalacia?
Keratomalacia is the most severe form of xerophthalmia. Xerophthalmia is the name for the eye signs of vitamin A deficiency, or too little vitamin A.
In keratomalacia, the cornea, the clear front layer of the eye, may swell and thicken, and then melt away. The cornea can be destroyed in just a few days.
Symptoms
Vitamin A helps eyesight, especially in low light. Early signs of xerophthalmia include night blindness and changes to the surface of the eye. A shortage of vitamin A leads to poorer night vision, called night blindness. The WHO lists these eye signs of vitamin A deficiency:
- Dry conjunctiva, the clear layer over the white of the eye.
- Dryness of the cornea.
- Bitot's spots, which are white, foamy patches on the eye surface.
- A corneal ulcer, an open sore on the cornea that can melt away.
Infection of the ulcer is common and can make the eye inflamed. Eye pain and lower vision can also happen.
Without treatment, the result can be a scarred cornea, a badly damaged cornea that bulges forward, or an eye that shrivels up. Most of these eye signs affect both eyes and can lead to blindness.
Causes and who gets it
Keratomalacia is an eye sign of vitamin A deficiency. Children with it are often malnourished. Children who seemed healthy can also get it after measles or diarrhea.
In wealthier countries, vitamin A deficiency is extremely rare unless other diseases cause it. Children with autism are at risk, and they often eat a narrower variety of foods. Inflammatory bowel disease can raise the risk. Pancreatic insufficiency, most often from cystic fibrosis, can raise the risk because the body cannot absorb fat. Premature babies are also at risk.
Acute vitamin A deficiency is most common in children aged 1 to 4 years.
How doctors diagnose it
A diet history and an eye exam are key to diagnosis. Small Bitot's spots may be easier to see with a slit lamp, a microscope with a bright light.
A blood test for serum retinol, the form of vitamin A in the blood, may help confirm the diagnosis. Doctors read the result along with the person's symptoms.
Treatment
Vitamin A supplements are the main treatment for the eye problems of this deficiency. Ideally, an ophthalmologist helps manage care. Vitamin A can rarely be toxic, so a doctor should guide treatment. Large doses in pregnancy can cause birth defects.
Many people with this problem also lack protein and calories, so a nutrition expert often helps.
When the cornea is involved, doctors swab it to test for germs. They then use antibiotic ointment to lower the risk of infection. Preservative-free artificial tears can keep the cornea moist. If there is an active ulcer, the eye is covered to protect its surface.
Surgery to rebuild the cornea, called keratoplasty, often leaves poor vision even if the graft survives.
Foods with a lot of vitamin A include:
- Eggs.
- Dairy products such as cheese and milk.
- Some types of fish, such as herring and salmon.
- Orange and yellow vegetables and fruits, such as carrots and sweet potatoes.
When to see a doctor
Xerophthalmia that affects the cornea needs urgent treatment. Get care right away if you or your child has these eye signs.
Without proper care, severe vitamin A deficiency can lead to death. Ask a doctor about night blindness, especially if there are risk factors such as selective eating habits.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can review diet and health history, order blood tests, and coordinate care with an eye doctor.
Common questions
Is keratomalacia caused by a lack of vitamin A?
Yes, keratomalacia is an eye sign of vitamin A deficiency. Children with keratomalacia are often malnourished.
Can keratomalacia cause blindness?
Yes, it can cause blindness. The cornea can be destroyed in just a few days.
Can keratomalacia be treated?
Yes, vitamin A supplements are the main treatment for the eye problems. Surgery to rebuild the cornea often leaves poor vision.
Is keratomalacia common in the United States?
No, vitamin A deficiency is extremely rare in developed countries unless other diseases cause it. Keratomalacia only comes with severe deficiency.
Sources
- Community Eye Health Journal (NCBI PMC) - The eye signs of vitamin A deficiency
- NCBI PMC - Recognizing Vitamin A Deficiency: Special Considerations in Low-Prevalence Areas
- MedlinePlus - Vitamin A
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
