Night vision improvement

Patient complaint of impaired vision at dusk and during night driving. Real causes: early cataract, uncorrected myopia, retinitis pigmentosa, vitamin A deficiency, dry eye, drug adverse effects. Supplement marketing of bilberry and carotenoids promises night-vision improvement based on a WWII RAF pilot legend. The Cochrane review 2008 and a BMJ systematic review 2004 found no clinical trials showing that bilberry or its extracts improve scotopic vision or dark adaptation in healthy adults.

1 drug

Also known as: Scotopic vision, Dark adaptation, Vision in low light

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

DBilberry (Vaccinium myrtillus fruit extract)Not recommended · Herbal preparation, EMA HMPC traditional herbal medicinal productBilberry fruit extract is promoted to improve night vision and help the eyes adapt to the dark. It has not shown convincing benefit for this use: there is no solid evidence that it actually affects vision in low light. When night vision gets worse, the cause is worth checking with an ophthalmologist, since it may come from vitamin A deficiency, a retinal problem, or other conditions that have proven treatments. Bilberry should not replace a treatment with proven benefit, or you risk losing time on care that works.

How to read tiers A–F

Evidence tiers belong to the drug-indication pair, not to the drug as a whole: the same substance can be A for one condition and F for another.

AStrong evidence – first or second line in international guidelines
BRecommended in selected cases
CStudy data contradict each other
DBenefit not proven, no documented harm
FDocumented harm, or risk without benefit