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A person fumbling in the dark, waving their hands around, trying to find the light in a door.

Dark Adaptation: What's That?

A few pages ago I mentioned dark adaptation. I know just about all of you have experienced the “joy” of reduced dark adaptation even though you may not know the term.

What is dark adaptation?

Problems with dark adaptation are noticed when we go from a brightly lit area - such as outdoors- to a poorly lit area - such as a house or restaurant. Who turned out the lights?!?! Everything is pitch black! I can’t see a thing! I have already stopped dead just inside a door because I was rendered blind by problems with dark adaptation. And it did not resolve in a few seconds. I was still standing there several minutes later. Sound familiar?

When do we experience dark adaptation?

Dark adaptation issues happen very early in our journey with age-related macular degeneration. I remember going to a yoga event on a sunny, summer day months before my official diagnosis. I stepped into the building and could not see a thing. It was scary.

Dark adaptation and retinal disease

Dark adaptation is so predictive of retina issues they have started to devise ways of using it in formal diagnostics. Maculogix, in their short piece on dark adaptation, cites the Alabama Study of Early Age-Related Macular Degeneration (ALSTAR) as having discovered 24% of older people with apparently normal macular health had poor adaptation to light to low light changes. Three years later, this same 24% of the people tested were found to have twice the rate of age-related macular degeneration of that found in the other 76% of the people. On top of that, they were discovered to be eight times more likely to have progressed into intermediate and advanced levels of the disease. Ouch! How do you like that for a prediction rate?

Measuring dark adaptation

The Maculogix article goes on to sing the praises of a certain type of machine that measures dark adaptation. A quick look online revealed there are actually several different forms of technology being sold to measure the problem. Do I have any idea which one may be better? No clue and I am not going to speculate. The take-home point here is this: If you know anyone who goes “blind” when they go from light to dark, including being hit full in the face with headlights, you might kindly suggest they be checked for retinal disease.

Taking precautions

You might also suggest they start to take precautions. Which precautions? The usual ones. In treating and curing retinal diseases like AMD there are still few options. Wear sunglasses. Get lots of vitamin A. Stop smoking. Lose weight. Lower your blood pressure. It is in the early stages and even pre-stages when you first see dark adaptation problems - that these precautions will give the most bang for the buck.

For those of us who have advanced to intermediate and advanced forms of retinal disease, the advice is still the same. While I am not hopeful any of those precautions will do anything above minuscule for my geographic atrophy, I do make an effort at heading off the life problems dark adaptation issues cause. You know, rushing into a dark restaurant and falling down a couple of stairs or not being able to see to find the bathroom until it is too late.

Managing dark adaptation

What I do is try to minimize the effects of bright light. Wear sunglasses and take them off only when you have stepped inside. Avert your gaze from on-coming headlights. Do what you can to not “bleach out” your photoreceptor chemicals to begin with. Try to reduce your recovery time.

That is about it for now. Remember, dark adaptation problems seem to be a pretty sure way to predict someone is starting on the road to retinal disease. Spread the word. Part of this journey is taking care of those who come after us. Go forth and tell! (With apologies to J. E. Sedona and the Christian Church ;) )

Editor's Note: As of August 2023, 2 drugs known as complement inhibitors — Syfovre® and Izervay™ — have been approved by the US Food and Drug Administration (FDA) to treat geographic atrophy (GA).

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This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The MacularDegeneration.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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