Walsh & Hoyt: Nutritional Optic Neuropathies

Proving a nutritional basis for an optic neuropathy is by no means a simple task. The first criterion is that the patient be nutritionally deficient and has been so sufficiently long to deplete nutrients. Evidence from epidemics indicates that this requires months. The reports of large numbers of cases of visual loss after economic and political upheavals suggest the possibility of a nutritional etiology. The patient should show evidence of undernutrition, usually manifested in such obvious forms as weight loss and wasting. Victims of nutritional optic neuropathy, however, are not necessarily emaciated. Other signs such as peripheral neuropathy, keratitis, or the cutaneous and mucous membrane stigmata of the avitaminoses are useful, when present.