Bitot's spots

Bitot's spots are the buildup of keratin located superficially in the conjunctiva of human's eyes. They can be oval, triangular or irregular in shape. The spots are a sign of vitamin A deficiency and associated with drying of the cornea. In 1863, the French physician Pierre Bitot (1822–1888) first described these spots.^[1] The spots may abate under replacement therapy.^[2] In ancient Egypt, this was treated with animal liver, which is where vitamin A is stored.^[3]

Bitot's spots
Other names	ICD10 = E50.1
Bitot's spot
Typical location of Bitot's spots
Specialty	Ophthalmology

Causes

A major cause of Bitot's spots is vitamin A deficiency (VAD).^[4] Rarely, pellagra due to deficiency of vitamin B₃ (niacin) may also cause Bitot's spots.^[5] They can also be caused by Colestyramine , which is a bile acid sequestrant which can reduce the absorption of fat soluble vitamins (Vitamins A, D, E, K)

Treatment

VAD is commonly treated with oral vitamin A supplements.^[6] Improvement of Bitot's spots is seen with high-dose vitamin A therapy.^[7] Bitot's spots non-responsive to vitamin A therapy may be removed surgically.^[8]