Living with RP and Night-Blindness
An Introduction to Retinitis Pigmentosa and its Most Common Symptom
Retinitis Pigmentosa (RP) is a genetic visual disorder with a number of sub-variants and symptoms, and which afflicts millions worldwide, myself included.
Despite this prolific status, it yet remains that very little is typically known about RP among those who have not encountered it directly in their own lives. This article is thus intended to provide an overview of the disease in layman's terms and from the viewpoint of someone who has lived with RP since birth. It is in no way meant to replace or counter the opinions or advice of a proper medical professional.
Nature of the Beast
As mentioned above, there a numerous varieties of RP, each with its own time of onset, degree of severity and set of symptoms. The overall uniting characteristic among these illnesses is the decay of photoreceptor cells, which are found in the retina and include two types – rods and cones. The former are largely responsible for peripheral vision and the absorption of light during darkened conditions, while the latter control central vision and differentiation between colours.
Whereas these cells die off naturally in all people, those with RP do not generate new rods and cones as would a healthy retina. The result is a slow decay of vision that manifests in myriad forms, including moderate to severe tunnel vision, difficulty following small or fast-moving objects and most predominantly, a disease-defining ailment known as ‘night-blindness’.
It should be noted at this point that RP is a progressive and as-yet untreatable illness, for as photoreceptors die without replacement, the eventual loss of all vision is a reality for many with this condition, dependant upon disease variant and severity.
Night-Blindness - the Loss of Light
An effective analogy for what it is to be night-blind would be to imagine going through life with a set of heavy sunglasses on at all times. Since RP-affected retinas do not absorb the same amount of light as do their healthier counterparts, vision during daylight hours with ample lighting may be quite functional, though as the amount of available light decreases, so too does the person’s quality of vision. What most would consider the mere onset of dusk or low dinner-lighting equates to near or even total darkness for someone with RP, though direct sources of illumination – lit bulbs or a television screen – will stand out as clearly visible 'islands'.
Blind as a Bat, but only When the Bats are Out
Speaking in terms of the night-blindness symptom alone, for those whose RP has not rendered them completely without sight, night-blindness puts one in the rather peculiar position of being visually disabled in some situations while remaining able to see almost normally in others.
This can lead to any number of awkward social encounters, especially when it comes to new or unfamiliar acquaintances. It is situations such as these, though where the well-rehearsed blurb explaining the apparent switch from blindness to sightedness cannot really be conveyed, that most with RP tend to dread.
Imagine approaching a bus-stop at night and with white cane in hand, though once within the bus’ well-lit interior, the cane may be traded for a book.
The looks that this can earn you range from suspicious glares to outright disgust, for in the eyes of your fellow commuters, you are a fraud, an abuser of the unanimous understanding the symbol of the white cane garners – he or she can’t see, give them some slack. In the minds of most, a person is either blind or is not.
This is simply not the case with RP.
The reality is that RP is a rather diverse condition, and one that can hardly be defined in its entirety here. For those looking to learn more, consider visiting a trained optometrist, or contacting the Foundation Fighting Blindness.
On a final and positive note, it should be mentioned that the treatments currently being developed for this condition are almost as diverse as its symptoms and in many cases, show definite promise.
Night-blindness (centre) vs. normal vision (sides)
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Artist's depiction of night-blindness
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Demonstration of RP-affected sight
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Normal vision vs. RP-related tunnel vision
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