When this teenage boy went to the doctor complaining of exhaustion, his test results came back relatively normal. Three years later, he went blind. Doctors couldn’t figure out why… until now.
Early Symptoms
This 14-year-old teen from the United Kingdom first visited a doctor after he began experiencing fatigue. He wasn’t taking any medication, had an appropriate body mass index for his height, and showed no visible signs of malnutrition.
Picky Eater
The boy had been labeled a “fussy eater” since the age of 11 when he purposely began avoiding certain food textures. That was when he began subsisting on a diet that would soon take a permanent toll on his health…
Five Foods
By the time he sought medical attention for tiredness at age 14, it was noted that he had anemia and a vitamin B12 deficiency. The teen’s diet became restricted to the same five foods: Pringles, white bread, fries, processed ham, and sausages.
Bad Habits
The doctors combated his conditions with a few simple injections. He received some suggestions for dietary changes, but nothing stuck. That was only the tip of the iceberg.
Back to the Doctor
One year later, the unidentified patient was back at the doctor for a different reason. This time, his symptoms were even more concerning.
Undiagnosable
The boy had developed hearing loss and was experiencing symptoms related to his vision. Doctors were unable to determine the cause and sent him to an ear, nose, and throat specialist.
The Illness Escalates
He had disregarded the doctor’s advice to change up his diet, continuing to exclusively consume processed carbs and fats. Unfortunately, nobody could figure out a diagnosis for the teen. Two years later, his condition had taken a turn for the worse…
Legally Blind
By the age of 17, the boy’s vision had deteriorated to the point of blindness. His visual acuity had declined to 20/200, which is considered legally blind in both the United States and the United Kingdom. Still, doctors couldn’t determine the catalyst.
Healthy on the Outside
The teenager said he didn’t drink alcohol, take drugs, or use any tobacco products. His BMI was still in the normal range. It was determined that the teenager had an issue with his optic nerve, but tests failed to point to an obvious cause.
Peculiar Deviation
There were no lesions on his optic nerve and genetic tests came back negative for any hereditary diseases. Finally, doctors noticed an anomaly in his metabolic test results…
Getting Closer
The teen had low copper and selenium levels, a high level of zinc, a shockingly low vitamin D level, and low bone density. All of these signs indicated poor nutrition…
Confession
When interrogated about his diet, the teenager finally confessed that his diet consisted of a daily order of fries from a nearby fish and chips shop, Pringles, white bread, and processed meats. The doctors were able to come up with a diagnosis at last.
Rare Disease
The boy was diagnosed with nutritional optic neuropathy, a dysfunction of the optic nerve when essential nutrients for nerve fiber function are in low supply. The condition is extremely rare, especially in developed countries, but can occasionally be found in alcoholics.
Abnormal Tendencies
While many go through a picky eating phase, limiting one’s diet to a handful of foods for many years is “not normal,” according to clinical nutritionist Lona Sandon.
Disordered Eating
The problem can be classified as an eating disorder when eating becomes “restricting to junk foods and causes multiple nutritional deficiencies.” The teen was also diagnosed with ARFID, or avoidant-restrictive food intake disorder.
Permanently Blind
The teen was later treated with nutritional supplements and referred him to mental health services in order to address his eating disorder. Doctors were able to stabilize his vision, but it didn’t improve. The boy’s vision loss is permanent.
He Waited Too Long
“Nutritional optic neuropathy, if it’s caught early, is very treatable and the vision problems all get better with treatment,” said Sr. Senize Atan, an ophthalmologist at the hospital where the teen was seen. Unfortunately, by the time he sought medical attention, the damage was already done.
The Unfortunate Reality
He presented initially with “blurred vision and blurred mainly in the center of his vision.” The teen’s peripheral vision remains intact. “He also had reduced color vision and there were no other signs to show that he had a dysfunction of the optic nerves,” said Dr. Atan.
It Could Have Been Worse
The teenager was given supplements to help improve his color vision, but his overall vision remained the same. “A good thing is that he didn’t get worse,” she added. “Had his nutritional deficiencies continued, he could well have caught even more serious problems.”
Case Study
His case was so unique that he became the center of a case study. In the case study, doctors warn physicians that ARFID is an eating disorder that may manifest without alterations to body weight or shape. A statement read: “As in this patient, BMI is often normal.”
Uncommon Condition
Nutritional optic neuropathy is especially rare in developed countries. The University of Iowa documented a case in which a 28-year-old man contracted the disease. His diet consisted solely of 1.9 liters of vodka per day.
Don’t Be Worried
Dr. Atan has clarified that any parents with children who are picky eaters should not be concerned about them developing vision loss, seeing as selective diets don’t tend to last very long.
Keep Your Cool
“Picky eating is often a phase that children go through and they grow out of,” she said. Dr. Atan noted that parental anxiety regarding a child’s eating habits will almost definitely make their behavior worse.
Work Slow
Atan said that it’s always better to introduce one or two new foods in each meal rather than overreacting to picky eating. She encourages parents not to “get too angry or confrontational if your child doesn’t accept those foods.”
When to Seek Medical Attention
Dr. Sandon offered advice for parents who fear their child may be developing an eating disorder. “Make an appointment with a registered dietitian nutritionist who specializes in pediatrics, to assess your child’s growth and development, and his/her diet for potential nutrient deficiencies,” she said. “And assess risk factors for disordered eating that might signal other concerns.”
Holes in the Diagnosis
Tom Sanders, a professor of nutrition at dietetics in London, criticized the port for relying too heavily on the patient’s own memory of his eating habits, failing to take into consideration external factors, like environmental exposure.
Is It Really True?
“Vitamin B12 deficiency can cause optic neuropathy but it is very unusual to find dietary deficiency when animal products are consumed e.g. ham and sausages which are significant sources of the vitamin B12,” Sanders said. Another professor, Gary Frost, made a similar argument.
Not All Was as It Seemed
Frost said it was incredibly rare for someone in the United Kingdom to have a diet so limited that it resulted in micronutrient deficiencies. However, the Bristol teen was malnourished, despite the fact that he ate every day and wasn’t hungry.
Difficulties in Life
Dr. Atan says his “blind spots right in the middle of the vision” will prevent him from ever being able to drive. The teen will also “find it really difficult to read, watch TV or discern faces.”
Living with Blindness
The teen is completely blind. He is still able to walk around on his own because he retained peripheral vision. However, his life will still be changed permanently.