Study Finds, Bitot-Like Spots in Children with Normal Vitami
A Bitot spot is a conjunctival lesion, classically associated with severe vitamin A deficiency. In this paediatric series, we describe conjunctival lesions indistinguishable from Bitot spots, seen in the presence of normal vitamin A levels.

This study was performed by review of case notes, including all patients with Bitot-like spots found to have normal serum vitamin A levels. Data collected included age at presentation, ophthalmic and systemic diagnoses, and the presence of recognised genetic mutations. Histopathology was reviewed in one case.

--10 patients with Bitot-like spots with laboratory-confirmed normal serum vitamin A levels were identified.

--The conjunctival lesions were indistinguishable clinically and histopathologically from classic Bitot spots and were noted to occur in a range of anterior segment pathologies, including aniridia, WAGR syndrome, Axenfeld–Rieger syndrome, and blepharokeratoconjunctivitis.

Conclusively, in the absence of vitamin A deficiency, Bitot-like patches are detected in children with a variety of anterior segment diseases.