GROUP 3

Shahida perveen 15-arid-3253

M Haseeb ahmad 15-arid-3214
Rida fatima 15-arid-3245
M Zain shahid 15-arid-3236
Maheen farhat 15-arid-3223
Sania khan 15-arid-3249
 NYCTALOPIA
(Night Blindness)
 Derived from Greek word NYKT: night and ALAOS:
blindness.
 Inability to see in the dark.
 Not a disease itself but maybe a symptom of other eye
disorder.
 Poor/impaired light adaptation (experience of reduced light
vision) which does not allow the people to see when it is dark.
CAUSES OF NIGHT BLINDNESS
ETIOLOGY:
This situation can be inherited, may develop in later stages of life, because of
some injury or malnutrition(vitamin-A deficiency). It maybe a symptom of some
other underlying problem, usually a retinal problem especially untreated
myopia(near sightedness)
CAUSES:
Vitamin A deficiency
Glaucoma
Cataract
Congenital night blindness
Nearsightedness (myopia)
Glaucoma medication
Retinitis Pigmentosa
Diabetes
EPIDEMIOLOGY
According to WHO, global prevalence of nightblindnss in
populations at risk 1995-2005. Retinitis pigmentosa has a
worldwide prevalence of 1 in 4000, with a total of more than 1
million affected individuals. The disease is inherited as autosomal
dominant (30% to 40%), autosomal recessive (50% to 60%). 
WHO regional estimates indicate that in Africa, the highest
proportion of preschool-age children affected by night blindness
is 2.0%, this value is four times of that estimated in South-East
Asia (0.5%). This also means that Africa has the greatest number
of preschool-age children affected with night blindness (2.55
million). A comparable and high proportion of pregnant women
affected by night blindness are in Africa (9.8%) and South-East
Asia (9.9%), each of which is estimated to have over 3 million
pregnant women affected.
SYMPTOMS
Night Blindness
Dryness of eye (xerosis)
Blurry vision
Retinal puncture lesions (inflamed spots, leakage of blood in
eye which can later on lead to blindness)
Visual field defects.
Corneal liquefaction
Difficulty in seeing during night driving.
Slow vision adaptation between bright and dim light
condition.
VITAMIN-A deficiency
MECHANISM:
Retinol is the form of vitamin A that circulates in blood, it is converted
into retinal which is important in VISUAL CYCLE which occurs in the retina
of eye.

VISUAL CYCLE:
In this cycle, RETINAL combines with the protein OPSIN to form the
visual pigment rhodopsin. When light strikes the retina, the retinal in
rhodopsin is changed from a curved molecule into straight one. This change
causes the retinal to separate from opsin and sends a nerve signal to the
brain. After the light stimulus has passed, the retinal can be converted back
to its curved form and rhodopsin can be regenerated. So in VIT-A
deficiency, the retinal cannot be replaced and night blindness occurs.
RETINITIS PIGMENTOSA

 A group of rare genetic disorders in which the rod

cells in the retina gradually breakdown or lose their
function to respond to the light. Patients suffering
from this genetic condition have progressive
nyctalopia and eventually their daytime vision may
also be affected(Hamarlopia)
Common symptoms include difficulty seeing at night
and a loss of side (peripheral) vision.
RETINITIS PIGMENTOSA
NYCTALOPIA RELATED CONDITIONS
CATARACT: PERIPHERAL CATARACT:
It is an age related disorder. This is opacity of lens of the eye or
Dense cloudy area formed in capsule.
the lens of eye. It develops This is now redirected as cortical
slowly & later interfere with cataract.
vision. Outer area of the retina is made up of
CAUSES: more rods than cones. As rods are
responsible for dim light vision, so loss
 UV radiations
of peripheral vision results in night
 Hypertension blindness.
 Smoking
 Obesity & diabetes
 Previous eye injury or surgery
 High myopia
 Family history.
 Cont…
Macular Degeneration:
The leading cause of severe,
irreversible vision loss in people
over age 60. It occurs when the
small central portion of the
retina, known as the macula,
deteriorates. The retina is the
light-sensing nerve tissue at the
back of the eye. So a dark blurry
area appears in center of the
vision.
This can be age related disorder or
occurs in Alzheimer's disease or
because of malnutrition.
 Cont…
Diabetic retinopathy:

 A diabetes complication that affects floaters

eyes. It's caused by damage to the
blood vessels of the light-sensitive
tissue at the back of the eye
(retina). At first, diabetic
retinopathy may cause no
symptoms or only mild vision
problems.
In the initial stages of diabetic
retinopathy, patients are generally
asymptomatic, but in more
advanced stages of the disease
patients may experience symptoms
that include floaters, distortion,
and/or blurred vision. 
 DIAGNOSIS
Night blindness can be diagnosed and treated by an
ophthalmologist, a physician who specializes in eye
disorders. Diagnosis begins with a detailed medical
history regarding the night blindness. Questions
include: severity of night blindness, when night
blindness began, did it occur gradually or suddenly, etc.
 An eye examination is performed. A slit lamp
examination, in which a narrow beam of intense light is
used to examine the internal components of the eye,
may also be performed. 
TREATMENT
TREAT THE UNDERLYING CAUSE!!!
Treatment method depends upon the cause of night blindness. This is as
simple as getting a new eyeglass prescription or switching glaucoma
medication or it may require surgery if caused by cataract.
 VIT-A deficiency: Treated by giving vitamin A supplements or the
provision of natural Vitamin A sources. Vitamin A in humans is
primarily obtained by conversion of beta-carotene, a pigment found in
fruits and vegetables. Food sources for beta-carotene include apricots,
broccoli, Brussels sprouts, cantaloupe, carrots, cherries, kale, lettuce,
mango, papaya, peaches, pumpkin, cabbage, seaweed, spinach, sweet
potatoes, watermelon.
 Retinitis pigmentosa: not completely curable but the rate of
progression can be reduced by intake of vit A supplements &
surgeries(retinal transplant).
 Myopia: use of corrective glasses or lenses or refractive surgery
 Glaucoma: switching to medication may help.
 Cont…
 Cataract: giving Vitamin E sources like sunflower seeds, almonds, spinach.
Lutein and zeaxanthin includes spinach, kale & green leafy vegetables.
 Cortical cataract: cataract surgeries. Intake of vitamin C (antioxidant).
Antioxidant supplements are beneficial for protecting the eyes and can act as
a natural sunscreen for the eye's delicate structures. Foods containing Omega
3 fatty acids reduces cataract risks like fish oil. omega-3 fatty acid, helps in the
development of retinal cells. It’s also thought to have a role in reducing
inflammation and helping cells of the retina and the cornea heal and
regenerate after damage due to light exposure and aging.

 Zinc is necessary to transport vitamin A from the liver to the retina, so zinc
supplementation (up to 25 mg daily) may help improve night vision.
 Docosahexaenoic acid (DHA) helps to increase rhodopsin levels and lines
the photoreceptor cells of the retina. DHA is converted from omega-3 fatty
acids , both of which are found in certain fish oils. The suggested daily dose
of DHA (from fish oils) is 500–1000 mg.
EYE HEALTH TIPS
 In addition to diet and supplements, there are some other things
you can do at home to promote eye health:
 Use a humidifier in your home if your house is dry. You may only
need to use it seasonally.
 Drink plenty of water. Although recommendations vary by weight,
adults should drink, roughly, between 1.5 liters (6 cups) and 2 liters
(8 cups) of fluid daily.
 Keep your eyes moist with artificial tears.
 Avoid environments with dusty or dirty air.
 Use cold compresses, cucumbers or cooled green or black tea bags
on your eyes.