Bitot's Spots- A 4-year-old boy was brought by his father to the ophthalmology clinic with a 1-year history of enlarging white deposits in both eyes and decreased night vision. On examination, the conjunctivae of both the right eye (Panel A) and the left eye (Panel B) appeared dry and wrinkled, with foamy, cream-colored deposits near the outer corners... The ocular findings were consistent with Bitot’s spots, which are accumulations of keratin, often intermixed with an overgrowth of Corynebacterium xerosis, that result from epithelial metaplasia caused by vitamin A deficiency. Vitamin A deficiency can also cause blindness, as a result of corneal ulceration with scarring, and particularly night blindness, as a result of dysfunction of rod photoreceptor cells... #NEJM #clinical #photo #ophth #bitot #spots #Corynebacterium #xerosis #keratin