Hemeralopia

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Hemeralopia
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Hemeralopia or day blindness is the inability to see clearly in bright light and is the exact opposite of nyctalopia (night blindness), the inability to see clearly in low light. [1] It is also called heliophobia. [2] It can be described as insufficient adaptation to bright light.

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In hemeralopia, daytime vision gets worse, characterised by photoaversion (dislike/avoidance of light) rather than photophobia (eye discomfort/pain in light), which is typical of inflammations of the eye. Nighttime vision largely remains unchanged due to the use of rods as opposed to cones (during the day), which are affected by hemeralopia and in turn degrade the daytime optical response. Hence, many patients feel they see better at dusk than in daytime.

The word hemeralopia comes from the Greek ημέρα hemera, "day", and αλαός alaos, "blindness". Hemera was the Greek goddess of day, and Nyx was the goddess of night. Hemeralopia has been used to describe night blindness rather than day blindness by many non-English-speaking doctors, causing confusion. [1]

Causes

Hemeralopia is known to occur in several ocular conditions. Cone dystrophy and achromatopsia, affecting the cones in the retina, and the anti-epileptic drug trimethadione are typical causes. Adie's pupil, which fails to constrict in response to light; aniridia, which is absence of the iris; and albinism, where the iris is defectively pigmented, may also cause this. Central cataracts, due to the lens clouding, disperses the light before it can reach the retina and is a common cause of hemeralopia and photoaversion in the elderly. Cancer-associated retinopathy (CAR), seen when certain cancers incite the production of deleterious antibodies against retinal components, may cause hemeralopia.

Another known cause is a rare genetic condition called Cohen syndrome (aka Pepper syndrome). Cohen syndrome is mostly characterized by obesity, mental retardation and craniofacial dysmorphism due to genetic mutation at locus 8q22–23. Rarely, it may have ocular complications such as hemeralopia, pigmentary chorioretinitis, optic atrophy or retinal/iris coloboma, having a serious effect on the person's vision.

Yet another cause of hemeralopia is uni- or bilateral postchiasmatic brain injury. [3] This may also cause concomitant nyctalopia. [3]

Management

People with hemeralopia may benefit from sunglasses. Wherever possible, environmental illumination should be adjusted to comfortable level. [3] Light-filtering lenses appear to help in people reporting photophobia. [3]

Otherwise, treatment relies on identifying and treating any underlying disorder.

The protagonist of the Bollywood movie Aankh Micholi suffers from this condition, which results in some hilarious incidences.

See also

Related Research Articles

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Albinism is a congenital condition characterized in humans by the partial or complete absence of pigment in the skin, hair and eyes. Albinism is associated with a number of vision defects, such as photophobia, nystagmus, and amblyopia. Lack of skin pigmentation makes for more susceptibility to sunburn and skin cancers. In rare cases such as Chédiak–Higashi syndrome, albinism may be associated with deficiencies in the transportation of melanin granules. This also affects essential granules present in immune cells, leading to increased susceptibility to infection.

<span class="mw-page-title-main">Retinitis pigmentosa</span> Gradual retinal degeneration leading to progressive sight loss

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Photophobia is a medical symptom of abnormal intolerance to visual perception of light. As a medical symptom, photophobia is not a morbid fear or phobia, but an experience of discomfort or pain to the eyes due to light exposure or by presence of actual physical sensitivity of the eyes, though the term is sometimes additionally applied to abnormal or irrational fear of light, such as heliophobia. The term photophobia comes from Greek φῶς (phōs) 'light' and φόβος (phóbos) 'fear'.

In visual physiology, adaptation is the ability of the retina of the eye to adjust to various levels of light. Natural night vision, or scotopic vision, is the ability to see under low-light conditions. In humans, rod cells are exclusively responsible for night vision as cone cells are only able to function at higher illumination levels. Night vision is of lower quality than day vision because it is limited in resolution and colors cannot be discerned; only shades of gray are seen. In order for humans to transition from day to night vision they must undergo a dark adaptation period of up to two hours in which each eye adjusts from a high to a low luminescence "setting", increasing sensitivity hugely, by many orders of magnitude. This adaptation period is different between rod and cone cells and results from the regeneration of photopigments to increase retinal sensitivity. Light adaptation, in contrast, works very quickly, within seconds.

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<span class="mw-page-title-main">Mammalian eye</span>

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<span class="mw-page-title-main">Persistent fetal vasculature</span> Medical condition

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<span class="mw-page-title-main">Jalili syndrome</span> Medical condition

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<span class="mw-page-title-main">Goldmann–Favre syndrome</span> Medical condition

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References

  1. 1 2 Ohba N, Ohba A (December 2006). "Nyctalopia and hemeralopia: the current usage trend in the literature". Br J Ophthalmol. 90 (12): 1548–9. doi:10.1136/bjo.2006.097519. PMC   1857511 . PMID   17114591.
  2. Gördüren, S. (1950). "Day-Blindness". British Journal of Ophthalmology. 34 (9): 563–567. doi:10.1136/bjo.34.9.563. PMC   1323631 . PMID   14777856.
  3. 1 2 3 4 Page 96 in: Zihl, Josef (2000). Rehabilitation of visual disorders after brain injury. East Sussex: Psychology Press. ISBN   0-86377-898-4.