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Abstract: Objective: We examined an adult patient who lost one eye due to severe keratomalacia secondary to self-induced vitamin A deficiency. Methods: This case report provides a clinical, ophthalmologic, and laboratory description in addition to a review of the medical literature. Results: A 33-y-old woman with a 17-y history of an eating disorder presented with bilateral conjunctival xerosis, an infected corneal ulcer in the right eye and a large descemetocele in the left eye. Laboratory and clinical findings were consistent with vitamin A deficiency. Despite a tectonic penetrating keratoplasty, her left eye perforated and had to be eviscerated. In parallel, vitamin A replacement improved her clinical status and the ocular findings in her right eye. Conclusions: The present report indicates that vitamin A deficiency secondary to eating disorders should be considered in the differential diagnosis of patients with severe dry eye and corneal ulceration. [Copyright &y& Elsevier]