Symptoms of the progressive genetic eye disease retinitis pigmentosa (RP) typically start showing during a person’s childhood (early onset) or early teen years, though they can also appear in adulthood. These symptoms, along with their order of appearance, can vary depending on which genes have mutated, and whether the retina’s rods or cones are affected first. In general, however, symptoms manifest in the following ways.

• Night blindness
• Narrowed field of vision
• Decreased ability to discern visual details 
• Inability to see colors

The degenerative nature of RP often means that people living with the condition are deemed legally blind by the age of 40 or 50, though this can differ from person to person.

In most forms of RP, the rods of the retina are affected first. Rods are involved in night vision, so one of the earliest and most common symptoms of RP as these cells die off is night blindness, or difficulty seeing in dim lighting or in the dark. It may take longer for your eyes to adjust to a dark room, and nighttime navigation, whether walking or driving, may likely prove both challenging and dangerous. 

Vision loss with RP tends to progress from peripheral (side) vision toward the central (front) vision. It begins with blind spots, fuzziness, and a greying or dimming of vision at the outside corners of the eyes. It may take a while to notice it.

Over time, the loss of peripheral vision creates “tunnel vision,” or a narrowing of the visual field, hindering your ability to see objects below and around you without turning or otherwise moving your head. You may misjudge spaces and distances, may stumble or bump into furniture or other objects.

The eventual loss of central vision can mean difficulty performing tasks that depend on visual details, such as reading, sewing, and even recognizing faces or familiar objects. For some people, recognizing printed letters becomes difficult before recognizing images does. This is another symptom that varies with the individual. 

Just as the rods of the retina are involved in night and low-lighting vision, the cones of the retina are involved in light and color vision. For people with RP that begins with damage to the rods and progresses to cone damage, the loss or distortion of color perception may be a sign of advanced disease.

For some people, however, the cones are the first to be affected by degeneration, so diminished central and color vision may be among the earliest symptoms experienced. 

RP can take many forms, and also be a feature of even more complex health conditions. These include, among others:

• Usher syndrome, in which a person is born with deafness along with RP
• Leber congenital amaurosis (LCA), in which babies are often born blind 
• Refsum disease, which, in addition to vision loss, causes loss of smell (anosmia) 
• Bardet-Biedl syndrome (BBS), which can affect multiple organs in the body 

Many symptoms of RP can also mimic or overlap with other eye diseases. Speak with your eye doctor to obtain an accurate diagnosis.