Anorexia Nervosa

Ophthalmic changes in severe anorexia nervosa: a case series

International Journal of Eating Disorders
By Philip S. Mehler, MD, FACP, FAED, CEDS


Objective: We describe the diagnosis and management of lagophthalmos, or failure of eyelid closure, in five patients with severe anorexia nervosa (AN) who complained of dry, irritated eyes and photophobia.

Method: Five patients with these findings are described retrospectively.

Results: Examination revealed lagopthalmos in the setting of ptosis and enophthalmos, with multiple other starvation-mediated medical complications.

Discussion: These eye findings, as complications of AN, have not been described in the literature. With careful protective measures, initiation of nutritional rehabilitation, and intensively monitored early refeeding, these patients' ocular abnormalities and associated symptoms resolved completely. Recognition of this pathology and appropriate management can prevent long-term morbidity in the form of permanent loss of visual acuity due to corneal abrasions and improve the outcomes for these patients with severe AN.

Written by

Philip S. Mehler, MD, FACP, FAED, CEDS

Dr. Philip S. Mehler began his career at Denver Health more than 35 years ago and was formerly its Chief of Internal Medicine and then Denver Health’s Chief Medical Officer (CMO) until he was promoted…

ACUTE Earns Prestigious Center of Excellence Designation from Anthem
In 2018, the ACUTE Center for Eating Disorders & Severe Malnutrition at Denver Health was honored by Anthem Health as a Center of Excellence for Medical Treatment of Severe and Extreme Eating Disorders. ACUTE is the first medical unit ever to achieve this designation in the field of eating disorders. It comes after a rigorous review process.

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