Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with progressive nyctalopia, peripheral visual field constriction, and difficulty with dark adaptation. Symptoms are chronic and slowly progressive, consistent with rod-cone dystrophy. No history of ocular trauma or inflammatory disease. Family history positive for similar visual impairment.
Clinical Examination Findings
BCVA: [OD/OS]. Slit-lamp exam: clear media, no evidence of uveitis. Dilated fundus exam: bilateral mid-peripheral bone-spicule pigmentary changes, arteriolar attenuation, and waxy pallor of the optic disc. OCT: thinning of the outer nuclear layer and loss of the ellipsoid zone. Goldmann perimetry: concentric peripheral field constriction.
Treatment Protocol
Management includes low-vision rehabilitation, use of tinted lenses for glare, and regular monitoring for complications such as cystoid macular edema and cataracts. Genetic counseling recommended. Consider referral for electroretinography (ERG) and genetic testing to confirm genotype.