Retinal Degeneration and Night Blindness: Key Insights - Ophthalmology

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Retinal degeneration, night blindness?


Hello Doctor, I recently visited a large hospital for an eye exam.
I underwent dark adaptation testing, visual field testing, and OCT, and was diagnosed with retinal dystrophy.
I've felt that my night vision has been worse than others for a long time, but no one in my family has night blindness; my father seems to have some color blindness, but my brother and mother do not.
The examination showed that only the central part of my retina is healthy, while the peripheral areas are abnormal.
There are not many photoreceptors, so I struggle to see in the dark.
The doctor mentioned that this condition may worsen with age and could eventually lead to cataracts, advising me to be cautious about UV exposure and to consume more lutein.
I also need to undergo genetic testing and electrophysiological examinations to identify which gene is involved, followed by ongoing monitoring.

I suddenly forgot to ask the doctor the following questions.
Since I am only 22 years old, I am very concerned about the rapid progression of this night blindness.
Is it true that there is a 100% chance of becoming blind in the future? Additionally, I have recently developed floaters; could this be related? I noticed that when I look at the sky or bright lights, I see flashes of light that feel a bit blinding, but they go away after a while.
Is this due to photophobia? (I have also been experiencing some sleep deprivation and eye strain lately; could this have an impact?) Thank you.

Miss Hsieh, 20~29 year old female. Ask Date: 2023/01/16

Dr. Gao Pilin reply Ophthalmology


Hello: Is it true that night blindness will inevitably lead to blindness in the future? It's not that pessimistic.
According to large-scale statistics, it is rare for retinitis pigmentosa to cause complete vision loss; about twenty percent of individuals may have a visual acuity of less than 0.1 in one eye.
However, half of the individuals over the age of sixty still maintain a visual acuity of at least 0.5 in one eye.
Please refer to: https://bit.ly/3WevliD.
Floaters are not related to night blindness.
Photophobia is a symptom that can occur when the eyes are inflamed, uncomfortable, overly fatigued, or dry.

Reply Date: 2023/01/16

More Info


Understanding retinal degeneration and night blindness can be quite complex, especially when you are faced with a diagnosis at a young age. It’s important to clarify some key points regarding your condition, the implications of retinal degeneration, and how it relates to your symptoms, including night blindness and floaters.

Firstly, retinal degeneration, particularly conditions like retinitis pigmentosa, can lead to night blindness due to the deterioration of photoreceptor cells in the retina. These cells, specifically rods, are responsible for vision in low-light conditions. Your experience of having poorer night vision compared to others is a common symptom of this condition. However, it’s crucial to understand that while retinal degeneration can progress, it does not necessarily mean that you will become completely blind. Statistics indicate that while some individuals may experience significant vision loss, many retain some level of functional vision throughout their lives. For instance, studies show that a significant percentage of individuals with retinal degeneration maintain a certain level of vision even into older age.

Regarding your concern about the potential for complete blindness, it’s important to have realistic expectations. While retinal degeneration can lead to progressive vision loss, complete blindness is relatively rare. Regular monitoring and follow-up with your ophthalmologist are essential to manage your condition effectively. They may recommend genetic testing and electrophysiological tests to better understand the specific type of retinal degeneration you have, which can also inform your prognosis.

Now, concerning your recent experience with floaters and sensitivity to light, these symptoms can be distressing but are not uncommon. Floaters are often caused by changes in the vitreous gel of the eye, which can occur with age or due to other factors such as myopia (nearsightedness). They are generally not directly related to retinal degeneration but can coexist with it. The sensitivity to light, or photophobia, can be attributed to several factors, including eye strain, fatigue, or inflammation. Given that you mentioned experiencing eye strain and fatigue, particularly after prolonged computer use, it’s likely that these factors are contributing to your discomfort.

Sleep deprivation can exacerbate symptoms of eye strain and sensitivity, leading to a heightened perception of light and visual disturbances. Ensuring adequate rest and managing screen time can help alleviate these symptoms. If you continue to experience significant discomfort or visual disturbances, it would be prudent to consult your eye care professional for further evaluation.

In summary, while your diagnosis of retinal degeneration and night blindness may seem daunting, it’s important to approach it with a balanced perspective. Regular follow-ups, lifestyle modifications (such as protecting your eyes from UV light and maintaining a healthy diet rich in antioxidants like lutein), and understanding your condition can empower you to manage your symptoms effectively. Always feel free to ask your healthcare provider any questions you may have during your visits, as they can provide you with the most accurate information tailored to your specific situation.

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