In Retinitis Pigmentosa, which portion of vision is typically lost first?

• A. Peripheral and night vision are lost first
• B. Central vision is lost first
• C. Color vision is lost first
• D. Peripheral color vision is lost first

Answer: (A)

Rods are affected first in retinitis pigmentosa, so night vision and the peripheral visual field are lost early. Patients often notice nyctalopia and a progressive narrowing of the field, sometimes described as tunnel vision. Central vision stays relatively intact initially because cones in the fovea are preserved longer, so central acuity and color perception tend to decline later in the disease. Funduscopic findings—bone-spicule pigmentation in the mid-periphery with vessel attenuation and optic disc pallor—reflect this rod-dominated degeneration as the condition advances. Therefore, peripheral and night vision are lost first.