Night blindness (nyctalopia) is the inability to see well at night or in poor light. It is not a disease in itself, but rather a symptom of an underlying problem, usually a retina problem. It is common for patients who are myopic to have some difficulties with night vision, but this is not due to retinal disease, but rather to optical issues.

Causes of Night Blindness

Night-blindness does not completely impede night vision, but it does make it considerably more difficult. It is not a separate condition, but rather a symptom which can be a sign of another kind of vision problem.

In some cases, severe myopia can make it more difficult to see at night or in low light conditions.

There are specific cells in our retina (the lining at the back of the eye) which are responsible for vision in low-light conditions. When these cells are affected by illness or vision problems, this can cause night-blindness.

• illnesses and eye conditions that can cause nyctalopia include:
• severe myopia;
• glaucoma (a disease which affects the optic nerve)
• the glaucoma drugs that contract the pupil
• cataracts (when the lens of the eye becomes clouded)
• diabetes
• retinitis pigmentosa (an eye disease which can lead to blindness)
• keratoconus (when the outer layer of the eye, the cornea, thins and becomes deformed)

In the case of vitamin A deficiency, nyctalopia can develop because the receptor-protein necessary for seeing in low-light conditions requires the synthesis of rhodopsin from vitamin A. The ability to see depends on two photoreceptors found in the rods and cones.

Rods and cones are found at the back of the eye, in the outermost region of the retina, with rods being used for night vision, and cones being used for bright light vision. They are made up of various segments, the outer one being made up of discs containing photoreceptors that absorb light.

Diagnosis of Night Blindness

The following problems can prompt a visit to the doctor to discuss nyctalopia:

• Trouble moving around the house at night
• Difficulties driving at night
• Avoiding trips in the dark in case of falls or injuries
• Being unable to or experiencing delay in attempts to see or recognize faces in dark places
• Experiencing delays in adjustments from light to darkness

Treatment of Night Blindness

The treatments for nyctalopia will vary depending on its underlying cause. Sometimes all that is needed to correct nyctalopia is a new or adjusted prescription for glasses, a change in medication (for glaucoma, for example) or surgery, as when cataracts are the underlying cause of nyctalopia.

There are some conditions causing nyctalopia that cannot be treated, such as the genetic condition retinitis pigmentosa.

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Sarah Rose

Journal Manager Journal of Eye Diseases and Disorders

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