Learn about the potential eye complications caused by anorexia nervosa, including lagophthalmos and enophthalmos, as well as the development of Wernicke's encephalopathy and vision changes. Discover the treatment options available for these eye conditions.
Understanding the Effects of Anorexia Nervosa on the Eyes
( Credit to: Psychologytoday )
Anorexia nervosa (AN) is a psychiatric condition characterized by restrictive eating, severe weight loss, and a fear of gaining weight. This disorder can have numerous medical complications, including damage to various organs in the body. One area that can be affected by AN is the eyes.
The eyes are complex organs that allow us to take in visual information. They are housed in the eye sockets, or orbits, within the skull. These orbits are lined with fat, known as orbital fat, which protects the eyes and allows them to move freely. Orbital fat also helps to suspend the eyes in place, giving them their typical appearance.
In individuals with AN, malnutrition is the primary cause of eye problems. One of the ways malnutrition affects the eyes is by causing a loss of orbital fat. This can lead to a condition called lagophthalmos, where the eyelids cannot fully close. As a result, the tear film over the eyes can evaporate, leading to dryness and irritation.
Another condition that can occur in individuals with AN is enophthalmos, where the eye globes sink into the orbits, giving the appearance of sunken eyes. While this condition is primarily aesthetic, it may also contribute to the development of lagophthalmos by retracting the upper eyelid.
Eye Complications of Anorexia Nervosa: Lagophthalmos and Enophthalmos
Lagophthalmos and enophthalmos are two eye conditions that can occur in individuals with AN. Lagophthalmos is characterized by the inability of the eyelids to fully close due to the loss of orbital fat. This can lead to dryness and irritation of the eyes as the tear film evaporates. Enophthalmos, on the other hand, causes the eye globes to sink into the orbits, resulting in sunken eyes. While enophthalmos is primarily a cosmetic concern, it can contribute to the development of lagophthalmos by retracting the upper eyelid.
In a series of case studies, it was found that individuals with AN can experience lagophthalmos and enophthalmos, leading to dry and irritated eyes. Treatment for these conditions typically involves using lubricating eye drops during the day and applying ointment to the eyes at night, along with weight gain to restore the lost orbital fat.
Wernicke's Encephalopathy: A Potential Complication of Anorexia Nervosa
Another eye-related complication of AN is the development of Wernicke's encephalopathy (WE), a neurological condition caused by a deficiency in vitamin B1. Individuals with AN are at a higher risk of developing WE due to their malnutrition. This condition can cause poor muscle coordination, mental confusion, and eye abnormalities such as uncontrolled eye movements, double vision, and eye muscle weakness.
Early detection and treatment of WE are crucial to prevent permanent brain damage or death. Treatment typically involves vitamin B1 supplementation through injections to address the deficiency.
Vision Changes in Anorexia Nervosa
Vision changes can also occur in individuals with AN. One study found that women with AN had reduced thickness in certain parts of the eyes involved in visual processing, as well as lower dopamine activity compared to women without AN. However, despite these changes, patients with AN did not report significant vision problems.
However, in a case study, a woman with AN experienced vision difficulties due to severe deficiencies in vitamin B12 and folic acid. These deficiencies, caused by her restrictive diet, led to blurred vision, an inability to read or recognize shapes, and darkness in her central field of vision. Treatment with vitamin B12 and folic acid supplementation reversed her vision difficulties.
Nutritional Optic Neuropathy: Damage to the Optic Nerve
Malnourishment during AN can lead to a condition called nutritional optic neuropathy, where the optic nerve becomes damaged due to nutritional deficits. This can interfere with the transmission of visual information from the eyes to the brain, affecting how we perceive what we see.
Further research is needed to understand the specific nutritional deficits that contribute to these eye complications in AN. It is also important to include eye examinations as part of the treatment process for individuals with AN to detect and address any eye concerns.