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Night blindness

Last reviewed: 10 Nov 2024
Last updated: 05 Sep 2023

Summary

Definition

History and exam

Key diagnostic factors

  • family history of vision loss
  • history of retinitis pigmentosa
  • congenital stationary night blindness
  • past medical history of vitamin A deficiency or malignancy
Full details

Other diagnostic factors

  • decreased visual acuity in dim light
  • variable pupillary responses (depending on underlying cause)
  • retinal vascular attenuation
  • visual field loss
  • peripheral chorioretinal degeneration
  • history of drugs that interfere with vitamin A metabolism
Full details

Risk factors

  • retinitis pigmentosa
  • congenital stationary night blindness
  • vitamin A deficiency
  • cancer-associated retinopathy
  • melanoma-associated retinopathy
  • gyrate atrophy
  • choroideremia
Full details

Diagnostic tests

1st tests to order

  • electroretinography (ERG)
  • slit-biomicroscopy and indirect ophthalmoscopy
Full details

Tests to consider

  • serum vitamin A level
  • next-generation-sequencing
Full details

Treatment algorithm

ACUTE

genetic night blindness

acquired night blindness

Contributors

Authors

Jonathan Smith, FRCOphth, MRCP

Consultant Ophthalmologist

Sunderland Eye Infirmary

Sunderland

UK

Disclosures

JS has received sponsorship from Novartis, Bayer, and DORC for meeting travel and accommodation. JS was awarded a research grant in 2017 by the British Vitreoretinal Society.

Muhammad Raza Cheema, MRCGP, MRes, FRCOphth, FEBO

Specialist Registrar

Ophthalmology

Sunderland Eye Infirmary

Sunderland

UK

Disclosures

MRC declares that he has no competing interests.

Wendy Adams, MRCP, FRCOphth

Consultant Ophthalmologist

Sunderland Eye Infirmary

Sunderland

UK

Disclosures

WA declares that she has no competing interests.

Acknowledgements

Dr Jonathan Smith, Dr Wendy Adams, and Dr Muhammad Raza Cheema would like to gratefully acknowledge the assistance of Ms Karen Bradshaw. KB declares that she has no competing interests.

Peer reviewers

Makoto Nakamura, MD

Associate Professor

Department of Ophthalmology

Nagoya University Graduate School of Medicine

Nagoya

Japan

Disclosures

MN declares that he has no competing interests.

Eric Amesbury, MD

Klara Spinks Fleming Fellow

Jules Stein Eye Institute

UCLA

Los Angeles

CA

Disclosures

EA declares that he has no competing interests.

Creig S. Hoyt, MD

Emeritus Professor and Chairman

Department of Ophthalmology

University of California

San Francisco

CA

Disclosures

CSH declares that he has no competing interests.

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