Nyctalopia - Wikipedia

Condition making it difficult or impossible to see in relatively low light Medical condition

Nyctalopia
Other names	Night blindness
Effect of night blindness. Left: normal night vision. Right: night-blind vision.
Specialty	Ophthalmology

Nyctalopia (/ˌnɪktəˈloʊpiə/; from Ancient Greek νύκτ- (núkt-) 'night' ἀλαός (alaós) 'blind, invisible' and ὄψ (óps) 'eye'),[1] also called night blindness, is a condition making it difficult or impossible to see in relatively low light. It is a symptom of several eye diseases. Night blindness may exist from birth, or be caused by injury or malnutrition (for example, vitamin A deficiency). It can be described as insufficient adaptation to darkness.

The most common cause of nyctalopia is retinitis pigmentosa, a disorder in which the rod cells in the retina gradually lose their ability to respond to the light. Patients with this genetic condition have progressive nyctalopia and, eventually, their daytime vision may also be affected. In X-linked congenital stationary night blindness, from birth the rods either do not work at all, or work very little, but the condition does not get worse.

Another cause of night blindness is a deficiency of retinol, or vitamin A1, found in fish oils, liver, and dairy products.

The opposite problem, the inability to see in bright light, is known as hemeralopia and is much rarer.

Since the outer area of the retina is made up of more rods than cones, loss of peripheral vision often results in night blindness. Individuals with night blindness not only see poorly at night but also require extra time for their eyes to adjust from brightly lit areas to dim ones. Contrast vision may also be greatly reduced.

Rods contain a receptor-protein called rhodopsin. When light falls on rhodopsin, it undergoes a series of conformational changes ultimately generating electrical signals which are carried to the brain via the optic nerve. In the absence of light, rhodopsin is regenerated. The body synthesizes rhodopsin from vitamin A, which is why a deficiency in vitamin A causes poor night vision.

Refractive "vision correction" surgery (especially PRK with the complication of "haze") may rarely cause a reduction in best night-time acuity due to the impairment of contrast sensitivity function (CSF) which is induced by intraocular light-scatter resulting from surgical intervention in the natural structural integrity of the cornea.[2]

Causes

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• Cataract (peripheral cortical)
• Certain medications, such as phenothiazines[3]
• Choroideremia
• Chronic pancreatitis - Presumably due to malabsorption of vitamin A[4]
• Glaucoma
• Oguchi disease
• Pathological myopia
• Refractive surgery (LASIK, photorefractive keratectomy, radial keratotomy)
• Retinal detachment
• Retinitis pigmentosa
• Sorsby's Fundus Dystrophy (Macular degeneration)
• Visual snow
• Vitamin A deficiency; often via xerophthalmia

Treatment

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Phentolamine as an eye drop is under development for the treatment of nyctalopia and is in phase 3 clinical trials for this use.[5][6]

Historical usage

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Aulus Cornelius Celsus, writing ca. 30 AD, described night blindness and recommended an effective dietary supplement, liver being a good source of vitamin A: "There is besides a weakness of the eyes, owing to which people see well enough indeed in the daytime but not at all at night; in women whose menstruation is regular this does not happen. But success sufferers should anoint their eyeballs with the stuff dripping from a liver while roasting, preferably of a he-goat, or failing that of a she-goat; and as well they should eat some of the liver itself."[citation needed]

Historically, nyctalopia, also known as moonblink, was a temporary night blindness believed to be caused by sleeping in moonlight in the tropics.[7]

In the French language, nyctalopie and héméralopie have inverse meanings, the first naming the ability to see in the dark as well as in plain light, and the second the inability to do so. It is thought that this inversion from Latin happened during the 2nd century AD,[8] even though the Ancient Greek νυκτάλωψ (nuktálōps) has been used in both senses.

Night blindness, sometimes referred to as gravel, was occasionally documented during the American Civil War, particularly within the Confederate States of America. Like rheumatism, night blindness was viewed as a condition that could be easily faked or exaggerated and, initially, people with night blindness were regarded with some suspicion. Some soldiers who reported symptoms of nyctalopia also presented with symptoms of scurvy, suggesting a fundamental cause of poor nutrition.[9]

Nyctalopia in animals

[edit] See also: Horse eye

Congenital stationary night blindness is also an ophthalmologic disorder in horses with leopard spotting patterns, such as the Appaloosa. It is present at birth (congenital), not sex-linked, non-progressive, and affects the animal's vision in conditions of low lighting.[10] Congenital stationary night blindness (CSNB) is usually diagnosed based on the owner's observations, but some horses have visibly abnormal eyes: poorly aligned eyes (dorsomedial strabismus) or involuntary eye movement (nystagmus).[10] In horses, CSNB has been linked with the leopard complex color pattern since the 1970s.[11] A 2008 study theorizes that both CSNB and leopard complex spotting patterns are linked to the TRPM1 gene.[12] The region on horse chromosome 1 to which the Lp gene has now been localized also encodes a protein that channels calcium ions, a key factor in the transmission of nerve impulses. This protein, found in the retina and the skin, exists in fractional percentages of the normal levels found in homozygous Lp/Lp horses and so compromises the basic chemical reaction for nerve impulse transmission.[10]

References

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1. ^ "nyctalopia". Dictionary.com Unabridged (Online). n.d. Retrieved 28 September 2015.
2. ^ Quesnel, NM; Lovasik, JV; Ferremi, C; Boileau, M; Ieraci, C (Jun 2004). "Laser in situ keratomileusis for myopia and the contrast sensitivity function". Journal of Cataract and Refractive Surgery. 30 (6): 1209–18. doi:10.1016/j.jcrs.2003.11.040. PMID 15177594. S2CID 21916978.
3. ^ Goldman, Lee (2012). Goldman's Cecil Medicine (24th ed.). Philadelphia: Elsevier Saunders. pp. 2429. ISBN 978-1-4377-2788-3.
4. ^ Lee A, Tran N, Monarrez J, Mietzner D (2019). "Case Report: Vitamin A Deficiency and Nyctalopia in a Patient with Chronic Pancreatitis". Optom Vis Sci. 96 (6): 453–458. doi:10.1097/OPX.0000000000001385. PMID 31107845.
5. ^ "Opus Genetics". AdisInsight. 16 January 2026. Retrieved 27 January 2026.
6. ^ Pepose J, Brigell M, Lazar E, Heisel C, Yousif J, Rahmani K, Kolli A, Hwang M, Mitrano C, Lazar A, Charizanis K, Sooch M, McDonald M (October 2022). "A randomized phase 2 clinical trial of phentolamine mesylate eye drops in patients with severe night vision disturbances". BMC Ophthalmol. 22 (1) 402. doi:10.1186/s12886-022-02621-6. PMC 9548101. PMID 36209072.
7. ^ Smyth, W. H. (1867). The Sailor's Word-Book. BLACKIE AND SON. p. 483. ISBN 0-85177-972-7. {{cite book}}: ISBN / Date incompatibility (help)
8. ^ Dimitrios Brouzas et al., Nyctalopia in antiquity: a review of the ancient Greek, Latin, and Byzantine literature., Ophthalmology, 108(10):1917-21, 2001.
9. ^ Wiley, Bell Irvin (2008) [First published 1948]. The Life of Johnny Reb: The Common Soldier of the Confederacy (Updated ed.). Louisiana State University Press. p. 255. ISBN 978-0-8071-3325-5.
10. ^ a b c Bellone, Rebecca R; Brooks SA; Sandmeyer L; Murphy BA; Forsyth G; Archer S; Bailey E; Grahn B (August 2008). "Differential Gene Expression of TRPM1, the Potential Cause of Congenital Stationary Night Blindness and Coat Spotting Patterns (LP) in the Appaloosa Horse (Equus caballus)". Genetics. 179 (4). Genetics Society of America: 1861–1870. doi:10.1534/genetics.108.088807. PMC 2516064. PMID 18660533.
11. ^ Witzel CA, Joyce JR, Smith EL. Electroretinography of congenital night blindness in an Appaloosa filly. Journal of Equine Medicine and Surgery 1977; 1: 226–229.
12. ^ Oke, Stacey, DVM, MSc (August 31, 2008). "Shedding Light on Night Blindness in Appaloosas". The Horse. Retrieved 2009-02-07.{{cite journal}}: CS1 maint: multiple names: authors list (link)

External links

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Classification	D ICD-10: H53.6 ICD-9-CM: 368.6 MeSH: D009755 DiseasesDB: 32761 SNOMED CT: 75390007
External resources	MedlinePlus: 003039

v t e Diseases of the human eye
Adnexa Eyelid Inflammation Stye Chalazion Blepharitis Meibomian gland dysfunction Entropion Ectropion Lagophthalmos Blepharochalasis Ptosis Blepharophimosis Xanthelasma Ankyloblepharon Eyelash Trichiasis Madarosis Distichiasis Trichomegaly Lacrimal apparatus Dacryoadenitis Epiphora Dacryocystitis Xerophthalmia Orbit Exophthalmos Enophthalmos Orbital cellulitis Orbital lymphoma Periorbital cellulitis Conjunctiva Chemosis Conjunctivitis allergic Pterygium Pseudopterygium Pinguecula Subconjunctival hemorrhage
Globe Fibrous tunic Sclera Scleritis Episcleritis Cornea Keratitis herpetic acanthamoebic fungal Exposure Photokeratitis Corneal ulcer Thygeson's superficial punctate keratopathy Corneal dystrophy Fuchs' Meesmann Corneal ectasia Keratoconus Pellucid marginal degeneration Keratoglobus Terrien's marginal degeneration Post-LASIK ectasia Keratoconjunctivitis sicca Corneal opacity Corneal neovascularization Kayser–Fleischer ring Haab's striae Arcus senilis Band keratopathy Vascular tunic Iris Ciliary body Uveitis Intermediate uveitis Hyphema Rubeosis iridis Persistent pupillary membrane Iridodialysis Synechia Choroid Choroideremia Choroiditis Chorioretinitis Focal choroidal excavation Polypoidal choroidal vasculopathy Lens Cataract Congenital cataract Childhood cataract Aphakia Ectopia lentis Retina Retinitis Chorioretinitis Cytomegalovirus retinitis Retinal detachment Posterior vitreous detachment Retinoschisis Ocular ischemic syndrome / Central retinal vein occlusion Central retinal artery occlusion Branch retinal artery occlusion Retinopathy diabetic hypertensive Purtscher's of prematurity Bietti's crystalline dystrophy Coats' disease Sickle cell photic Macular degeneration Retinitis pigmentosa Retinal haemorrhage Central serous retinopathy Macular edema Epiretinal membrane (Macular pucker) Vitelliform macular dystrophy Leber's congenital amaurosis Birdshot chorioretinopathy Other Glaucoma / Ocular hypertension / Primary juvenile glaucoma Floater Leber's hereditary optic neuropathy Ocular hypotony Red eye Globe rupture Keratomycosis Phthisis bulbi Persistent fetal vasculature Persistent tunica vasculosa lentis Familial exudative vitreoretinopathy Vogt-Koyanagi-Harada disease
Pathways Optic nerveOptic disc Optic neuritis optic papillitis Papilledema Foster Kennedy syndrome Optic atrophy Optic disc drusen Optic neuropathy Ischemic anterior (AION) posterior (PION) arteritic anterior (AAION or arteritic AION) non-arteritic anterior (NAION) Kjer's Leber's hereditary Toxic and nutritional StrabismusExtraocular musclesBinocular visionAccommodation Paralytic strabismus Ophthalmoparesis Chronic progressive external ophthalmoplegia Kearns–Sayre syndrome palsies Oculomotor (III) Fourth-nerve (IV) Sixth-nerve (VI) Other strabismus Esotropia / Exotropia Hypertropia Heterophoria Esophoria Exophoria Cyclotropia Brown's syndrome Duane syndrome Other binocular Conjugate gaze palsy Convergence insufficiency Internuclear ophthalmoplegia One and a half syndrome Refraction Refractive error Hyperopia Myopia Astigmatism Anisometropia / Aniseikonia Presbyopia Vision disordersBlindness Amblyopia Leber's congenital amaurosis Diplopia Scotoma Color blindness Achromatopsia Dichromacy Monochromacy Nyctalopia Oguchi disease Blindness / Vision loss / Visual impairment Anopsia Hemianopsia binasal bitemporal homonymous Quadrantanopia subjective Asthenopia Hemeralopia Photophobia Scintillating scotoma Pupil Anisocoria Argyll Robertson pupil Marcus Gunn pupil Adie syndrome Miosis Mydriasis Cycloplegia Parinaud's syndrome Other Nystagmus Childhood blindness
Infections Trachoma Onchocerciasis

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