Treatment algorithm

Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups: see disclaimer

ACUTE

genetic night blindness

1st line – vitamin A supplement

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ACUTE
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genetic night blindness
1st line – 

vitamin A supplement

Inherited conditions that cause night blindness affect the structures within the retina or choroid, and are referred to as retinal or choroidal dystrophies. Retinitis pigmentosa and congenital stationary night blindness are the most common. No definitive treatment exists for most cases of genetic night blindness, but encouraging patients to take vitamin A supplements may slow disease progression.[36][37]​​​ Although one Cochrane review reported that vitamin A offered no clear benefits to patients with retinitis pigmentosa, the treatment did not cause harm.[38] Be aware of the potential for teratogenicity with vitamin A supplementation in vitamin-replete pregnant women.[35]

Primary options

vitamin A (retinol): 15,000 units orally once daily

acquired night blindness

1st line – healthy balanced diet including food rich in vitamin A

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ACUTE
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acquired night blindness
1st line – 

healthy balanced diet including food rich in vitamin A

Acquired night blindness is primarily secondary to vitamin A deficiency (which usually occurs due to an underlying systemic disease). If a deficiency is found, a healthy diet including food rich in vitamin A (e.g., liver, carrots, milk, egg yolks) or an oral supplement of vitamin A may be recommended.

In many countries, vitamin A deficiency is uncommon. It is important to exclude differentials that may lead to blurred vision made worse by low light levels rather than true night blindness (e.g., cataracts, myopia, glaucoma).

Consider – vitamin A supplement

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ACUTE
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acquired night blindness
Consider – 

vitamin A supplement

Treatment recommended for SOME patients in selected patient group

Drugs that affect vitamin A metabolism, particularly retinoic acid derivatives, can cause night blindness.[13] There is evidence to suggest that vitamin A supplementation may reverse night blindness in patients treated with retinoic acid derivatives.[39]​ Although vitamin A deficiency is extremely rare in high-income countries (e.g., the US), it is a serious public health concern in many low-income regions (e.g., Africa, Southeast Asia), where it particularly affects young children and pregnant women.[17]​ Be aware of the potential for teratogenicity with vitamin A supplementation in vitamin-replete pregnant women.[35]

Primary options

vitamin A (retinol): 15,000 units orally once daily

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Please note that formulations/routes and doses may differ between drug names and brands, drug formularies, or locations. Treatment recommendations are specific to patient groups. See disclaimer

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