6th February 2024

A 45-year-old male presents with progressive loss of vision in his left eye.

A 45-year-old male presents with progressive loss of vision in his left eye. This initially started as night blindness that progressed into blurry vision and bilateral photophobia. Examination revealed dry, thickened conjunctiva with a dull-hazy cornea and wrinkled appearance. Foamy-white opaque deposits are noted at the bulbar conjunctiva. 

He has recently had an extensive bowel operation with resulting short gut syndrome. 

Which of the following is the likely underlying diagnosis?