Night Vision Problems in High Myopia Patients

Night vision deterioration?

I have high myopia (one eye at -10.00 diopters and the other at -9.25 diopters).
I have always had poor night vision and have difficulty seeing in low-light conditions.
Recently, I have found it challenging to ride my bike at night, especially in areas without streetlights, where I cannot see ahead at all and can only make out the taillights of vehicles.
I wear contact lenses with a prescription of -9.00 diopters; could this be insufficient? However, my daytime vision is normal.
I would like to know if this is a symptom of night blindness or retinal detachment, as a doctor previously mentioned that I am at high risk.

Duo Duo, 20~29 year old female. Ask Date: 2017/08/11

Dr. Cai Wenyuan reply Ophthalmology

Hello, your issue may require a medical examination.
Thank you.

Reply Date: 2017/08/11

More Info

Understanding night vision problems in individuals with high myopia (severe nearsightedness) can be complex, as it involves various factors related to the structure and function of the eye. High myopia, defined as a refractive error greater than -6.00 diopters, is associated with an increased risk of several ocular complications, including retinal detachment, macular degeneration, and other retinal pathologies.
Your experience of poor night vision, particularly in low-light conditions, is not uncommon among individuals with high myopia. This condition can be attributed to several factors:
1. Reduced Rod Function: The retina contains two types of photoreceptor cells: rods and cones. Rods are responsible for vision in low-light conditions, while cones are responsible for color and daylight vision. In high myopia, the elongation of the eyeball can lead to changes in the retina that may affect rod function, resulting in difficulties seeing in dim lighting.

2. Night Blindness (Nyctalopia): This condition refers to the inability to see well at night or in low-light conditions. It can be caused by various factors, including retinal diseases, vitamin A deficiency, or inherited conditions. While your symptoms may suggest night blindness, it is essential to differentiate this from other potential issues, such as retinal detachment or degeneration, especially given your high-risk status.

3. Visual Acuity and Prescription: You mentioned wearing contact lenses with a prescription of -9.00 diopters, while your actual refractive error is higher. If your lenses do not fully correct your vision, it could contribute to your difficulties in low-light situations. It is crucial to have your prescription regularly updated to ensure optimal vision correction.

4. Retinal Health: High myopia is associated with an increased risk of retinal complications, including retinal tears or holes, which can lead to vision problems. If you have been informed that you are in a high-risk group, it is vital to have regular eye examinations to monitor your retinal health. Symptoms such as flashes of light, floaters, or sudden changes in vision warrant immediate medical attention.

5. Adaptation to Light: The ability of your eyes to adapt from darkness to light (and vice versa) can also affect your night vision. If your eyes take longer to adjust to changes in lighting, this could contribute to your difficulties in low-light situations.

6. Other Factors: Conditions such as dry eyes, fatigue, or even systemic issues like diabetes can also affect night vision. If you are experiencing eye strain or discomfort, it may be worthwhile to discuss these symptoms with your eye care provider.

In conclusion, while your symptoms may suggest night blindness, it is essential to consider the broader context of your eye health, particularly given your high myopia. Regular follow-ups with an ophthalmologist are crucial to monitor for any potential retinal issues and to ensure that your vision correction is adequate. If you have concerns about your night vision or any other symptoms, do not hesitate to seek further evaluation. Your eye health is paramount, and early intervention can help prevent more severe complications in the future.

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