Bitot's spots

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Bitot's spots
Other names: ICD10 = E50.1
Typical location of Bitot's spots

Bitot's spots are the buildup of keratin located superficially in the conjunctiva of human's eyes. They can be oval, triangular or irregular in shape. The spots are a sign of vitamin A deficiency and associated with drying of the cornea. In 1863, the French physician Pierre Bitot (1822–1888) first described these spots.[1] The spots may abate under replacement therapy.[2] In ancient Egypt, this was treated with animal liver, which is where vitamin A is stored.[3]

Signs and symptoms

In terms of the clinical presentation we see typically dry-appearing triangular patches of xerosed conjunctiva ( found temporal to cornea)[4]


Major cause of Bitot's spot is vitamin A deficiency (VAD).[5] Rarely, pellegra due to deficiency of vitamin B3 (niacin) may also cause Bitot's spots.[6]


Bitot's spots at the temporal limbus

The evaluation of the affected individual is as follows:[4]


VAD is commonly treated with oral vitamin A supplements.[7] Improvement of Bitot's spots is seen with high-dose vitamin A therapy.[4] Bitot's spots non-responsive to vitamin A therapy may be removed surgically.[8]


  1. Shukla, M; Behari, K (Jul 1979). "Congenital Bitot spots". Indian Journal of Ophthalmology. 27 (2): 63–4. PMID 541036. Archived from the original on 2022-02-09. Retrieved 2022-03-22.
  2. Ram, Jagat; Jinagal, Jitender (2018). "Bitot's Spots". New England Journal of Medicine. 379 (9): 869. doi:10.1056/NEJMicm1715354. PMID 30157394. S2CID 52126826.
  3. Numitor, Gerd (February 2012). Bitot's Spots. Flu Press. ISBN 978-620-0-57824-2.
  4. 4.0 4.1 4.2 "Management of Bitot's Spots". American Academy of Ophthalmology. 1 December 2016. Archived from the original on 16 May 2022. Retrieved 5 September 2022.
  5. Gilbert, Clare (2013). "The eye signs of vitamin A deficiency". Community Eye Health. 26 (84): 66–67. ISSN 0953-6833. PMC 3936686. PMID 24782581.
  6. Levine, Robert A.; Rabb, Maurice F. (1 November 1971). "Bitot's Spot Overlying a Pinguecula". Archives of Ophthalmology. 86 (5): 525–528. doi:10.1001/archopht.1971.01000010527007. PMID 5315641. Archived from the original on 17 October 2021. Retrieved 22 March 2022.
  7. "Vitamin A Deficiency Treatment & Management: Medical Care, Consultations, Diet". 9 November 2019. Archived from the original on 16 May 2022. Retrieved 22 March 2022.
  8. Themes, U. F. O. (11 September 2016). "Bitot's Spots". Ento Key. Archived from the original on 19 July 2022. Retrieved 22 March 2022.

External links