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'Picky eating' teen's blindness caused by a junk food diet

FriesA “picky eater” UK teen who ate nothing but chips and other junk food for years, slowly went blind as a result of his poor diet, according to a case report in the journal Annals of Internal Medicine.

LiveScience. reports that the teen's problems began at age 14, when he went to his GP complaining of tiredness. Blood tests showed he had anaemia and low levels of vitamin B12, the report said. He was treated with injections of vitamin B12 along with advice on how to improve his diet.

However, by age 15, he developed hearing loss and vision problems, but doctors couldn't seem to find the cause — results from an MRI and eye exam were normal.

Over the next two years, the teen's vision got progressively worse. When the boy was 17, an eye test showed that his vision was 20/200 in both eyes, the threshold for being "legally blind".

Further tests showed the teen had developed damage to his optic nerve. In addition, the teen still had low levels of vitamin B12, along with low levels of copper,  selenium and vitamin D.

These deficiencies prompted doctors to ask the teen about the foods he ate. "The patient confessed that, since elementary school, he would not eat certain textures of food," the authors, from the University of Bristol, wrote in the report. He told doctors that the only things he ate were fries, chips — specifically, Pringles — white bread, processed ham slices and sausage.

After ruling out other possible causes for his vision loss, the teen was diagnosed with nutritional optic neuropathy, or damage to the optic nerve that results from nutritional deficiencies. The condition can be caused by drugs, malabsorption of food, poor diet or alcohol abuse. "Purely dietary causes are rare in developed countries," the authors said.

Vision loss from nutritional optic neuropathy is potentially reversible if caught early. However, by the time the teen was diagnosed, his vision loss was permanent. What's more, wearing glasses would not help the teen's vision, because damage to the optic nerve cannot be corrected with lenses, said study lead author Dr Denize Atan, a consultant senior lecturer in ophthalmology at Bristol Medical School and Bristol Eye Hospital.

The teen was prescribed nutritional supplements, which prevented his vision loss from getting any worse.

The teen was also referred to mental health services for an eating disorder. The researchers note that the teen's diet was more than just "picky eating" because it was very restrictive and caused multiple nutritional deficiencies.

A relatively new diagnosis known as "avoidant-restrictive food intake disorder" (previously known as "selective eating disorder") involves a lack of interest in food or avoidance of foods with certain textures, colors, etc., without concern to body weight or shape. The condition usually starts in childhood, and patients often have a normal body mass index (BMI), as was the case for this patient, the authors said.


Atan said there is a lack of awareness among healthcare professionals and the public about the link between poor diet and sight loss. “What’s unusual about this case is the extreme picky eating and the fact it had gone on for quite some time, that the diagnosis had been missed and the visual loss had become permanent. The link between poor nutrition and vision has been known about for quite some time, at least among specialists in neuro-ophthalmology. The problem is that awareness among other health professionals isn’t quite so high.”

Background: Popular media have highlighted the risks for poor cardiovascular health, obesity, and cancer associated with junk food, but poor nutrition can also permanently damage the nervous system, particularly vision.
Objective: To alert clinicians of the visual complications of a diet restricted to junk food.

Rhys Harrison; Vicki Warburton; Andrew Lux; Denize Atan

[link url=""]Live Science report[/link]
[link url=""]Annals of Internal Medicine letter abstract[/link]

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