When Night Vision Fades: Understanding Retinitis Pigmentosa, Living Beyond The Diagnosis

KUALA LUMPUR, Oct 7 (Bernama) -- Retinitis Pigmentosa (RP), a rare genetic eye condition affecting the retina, could cause progressive retinal degeneration, leading to night blindness and the gradual loss of peripheral vision.

While there is currently no cure for the condition, early diagnosis and proper care can help patients manage it better, maximise their remaining vision and improve their quality of life.

Sunway Medical Centre, Sunway City (SMC) consultant ophthalmologist, medical retina and uveitis specialist Dr Tara Mary George said RP was not a single disease, but a group of inherited retinal conditions in which the retina did not function properly from the beginning.

“The retina works much like a processing centre that converts light into signals, so the brain receives it as vision. In RP, genetic mutations disrupt the process, especially in rod cells, which are responsible for seeing in low light and peripheral vision,” she said in a statement, today.

She noted that one of the earliest signs was difficulty seeing in dimly lit environments, with a common clue being trouble navigating a darkened room, such as a cinema.

“When lights go off, most people’s eyes adapt quickly but someone with RP may take much longer or not adapt well at all. As the condition progresses, patients may start to have tunnel vision and bumping into things as everything on the sides is dimmed out,” she said.

Dr Tara explained that although RP was a genetic condition, no two patients experienced it in exactly the same way, with some developing symptoms during childhood while others only noticed changes in their vision later in life, depending on the specific genetic mutation involved.

“If more critical parts of the retina are affected, the symptoms appear sooner and are usually worse. In milder cases, vision changes may only become noticeable in adulthood,” she said.

Dr Tara said RP had varied inheritance patterns due to its different genetic causes, with some forms running in families while others could occur without a known family history, which was why it was often referred to as an “inherited retinal dystrophy”.

She said diagnosing RP went beyond a routine eye examination and usually began with a detailed medical history, followed by specialised tests such as visual field assessments and optical coherence tomography (OCT) scans to detect early changes in vision and retinal structure.

Dr Tara said while an electroretinogram (ERG) could be used in certain cases to measure the retina’s electrical response to light, access to the test remained limited in Malaysia.

She advised individuals experiencing persistent night vision problems or difficulty seeing objects from the sides to consult an eye specialist for a proper assessment rather than simply updating their glasses.

Meanwhile, SMC consultant ophthalmologist and medical retina and uveitis specialist Dr Daphne Teh said although a diagnosis of RP could feel overwhelming, care today focused on helping patients adapt to the condition and continue living independently.

“We monitor patients regularly to track progression and treat any complications that arise. Follow-up care may include vision testing, retinal imaging, and treatment for related issues such as cataracts or macular swelling,” she said.

Beyond clinical care, Dr Daphne said practical lifestyle adjustments, such as improving lighting at home, reducing night driving and organising living spaces for safety, could help patients navigate daily life more confidently, alongside early referral to low-vision rehabilitation services.

She also highlighted how advances in technology were transforming the way patients with RP lived and worked, with tools such as digital magnifiers, text-to-speech software and smartphone applications helping them read, recognise objects and maintain their independence.

Dr Daphne stressed that while artificial intelligence applications that describe surroundings and read text aloud in real time could be life-changing for patients, emotional support was equally vital in helping them continue their studies, work and lead fulfilling lives.

Both specialists said that while ongoing research, including gene therapy, was opening up new possibilities for the future, raising awareness, early detection and timely support remained essential to helping patients manage their condition and maintain their quality of life.

--BERNAMA