The symptoms: The teen was brought to his family's general practitioner because he felt unusually tired. His doctor asked about the boy's eating habits and described him as a "fussy eater" in notes from the appointment. The doctor also indicated that the teen had no symptoms other than tiredness, according to a report of the case.
What happened next: Later, at age 15, the teen began developing problems with his sight. An eye exam detected no abnormalities, and the ophthalmologist was unable to determine the cause of the vision loss, which worsened over time. When the patient was 17 years old, his general practitioner referred him to a neuro-ophthalmologist for further testing. (Neuro-ophthalmologists can assess vision problems related to the nervous system.)
When asked, the patient denied using drugs, alcohol or tobacco, and his eyes showed no signs of disease, nor were they scarred or injured. The results of a neurological exam were normal.
The diagnosis: The patient admitted that he was no longer taking the recommended B12 injections. (The case report did not indicate exactly when he had stopped.) His body mass index (BMI) was normal, and he was of average weight for his height. But because his B12 levels were low, the doctors questioned him about his diet.
National Eating Disorders AssociationHe replied that he could not tolerate certain food textures; as a result, since elementary school, he had avoided most foods. For years, his daily diet consisted of fast-food french fries, white bread, potato chips, sausages and processed ham.
The treatment: The doctors prescribed the teen supplements to correct his nutritional deficiencies and referred him to mental health services to treat his food aversions, which the doctors identified as a type of eating disorder.
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In some instances, this type of neuropathy results from inflammatory bowel disease or bariatric surgery, which limit the body's absorption of certain nutrients. It can also stem from restrictive diets that are not adequately supplemented with missing vitamins and minerals.
Moving forward, "nutritional optic neuropathy should be considered in any patient with unexplained vision symptoms and poor diet, regardless of BMI," the authors wrote in the report.
This article is for informational purposes only and is not meant to offer medical advice.
Can you guess the diagnosis in these strange medical cases? Find out with our diagnostic dilemma quiz!
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