Vitamin B12 Deficiency as a Cause of Neurotrophic Keratopathy

Nader Nassiri1, 2, Farhad Assarzadegan3, Mansoor Shahriari1, 2, *, Hamid Norouzi1, 2, Sara Kavousnezhad2, Nariman Nassiri4, Kourosh Sheibani5
1 Department of Ophthalmology, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2 Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3 Department of Neurology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
4 Jules Stein Eye Institute, University of California at Los Angeles, Los Angeles, USA
5 Basir Eye Health Research Center, Basir Eye Clinic, Tehran, Iran.

© 2018 Nassiri et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Mansoor Shahriari, Imam Hoessein Medical Center, Shahid Madani St., Tehran, Iran; Tel: +989121943942; Email:



Neurotrophic keratitis is a rare degenerative corneal disease caused by an impairment of trigeminal corneal innervation, leading to a decrease or absence of corneal sensation. Here, we present a case of neurotrophic keratopathy caused by B12 deficiency in a 34 years old man who had a progressive decrease in visual acuity and corneal involvement since 3 months before being referred to our ophthalmology clinic.

Result and Discussion:

Based on our clinical findings and with the diagnosis of B12 deficiency we started B12 treatment for the patient. After 3 weeks the patient showed a dramatic response with corneal sensation reversal, an increase of visual acuity, improved neurotrophic keratopathy and significantly improved neurological findings. To the best of our knowledge, there is no report regarding vitamin B12 deficiency induced keratopathy and this is the first report that describes this aspect of vitamin B12 deficiency.

Keywords: Keratopathy, Deficiency, Vitamin, Neurotrophic, Vitamin B12, Corneal Sensation.