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BACKGROUND: Vitamin and trace element deficiencies may cause visual disturbances. Before starting a substitutional therapy, specific investigations should be performed. HISTORY AND SIGNS: We present a kidney-transplanted patient who suffered for 6 months from night blindness. The electroretinography showed a severe decrease of the rod activity. Except for an irregular pigmentation in the far periphery, the fundus appeared normal. These findings were indicative of a vitamin A and zinc deficiency. The laboratory tests showed decreased vitamin A and zinc serum levels. THERAPY AND OUTCOME: After three months of substitutional therapy the electroretinogram had normalized and the patient was free of symptoms. CONCLUSIONS: Visual disturbances due to vitamin and trace element deficiencies are rare in Europe. If suspected, since the diagnosis and the treatment of nutritional deficiencies are simple, specific investigations and a substitutional therapy should be initiated.