For most of us, poor vision in the dark is something we blame on “tired eyes” or too much screen time. But for millions worldwide — including many in India — it signals something deeper: Vitamin A deficiency, an age-old problem quietly resurfacing in the modern age of processed food and dietary shortcuts.

At Nellikka.life, we revisit what this essential vitamin does for your eyes, why its lack leads to night blindness, and how simple food choices can literally brighten the way you see the world.

What Is Night Blindness?

Night blindness (nyctalopia) is the inability to see clearly in low light or darkness. It’s not a disease by itself but a symptom — usually of Vitamin A deficiency, which impairs the eye’s ability to adapt to dim light.

People with night blindness struggle with:

• Driving at night or walking in poorly lit streets
• Adjusting from bright sunlight to darker indoors
• Needing more time to focus in dimly lit rooms

In children, it can show up as hesitation or fear of darkness; in adults, it often manifests as eye fatigue and reduced visual sharpness after sunset.

The Science Behind Vitamin A and Vision

Vitamin A plays a vital role in retinal function — specifically in forming a molecule called rhodopsin, the light-sensitive pigment in the eye’s rods (cells that detect light and dark).

Here’s how it works:

• When light enters the eye, rhodopsin helps convert it into electrical signals the brain interprets as vision.
• Without enough Vitamin A, rhodopsin can’t regenerate efficiently, making it difficult to see in low light conditions.

Over time, prolonged deficiency damages the cornea (front surface of the eye), causing dryness, ulcers, and — in severe cases — permanent blindness.

Early Warning Signs to Watch For

Vitamin A deficiency doesn’t appear overnight. It builds silently.
Some early red flags include:

• Difficulty seeing in dim light or adjusting to darkness
• Dry or gritty sensation in the eyes
• Frequent eye infections or redness
• Bitot’s spots — white, foamy patches on the conjunctiva
• Dry skin, brittle hair, or weak immunity

According to the World Health Organization (WHO), Vitamin A deficiency remains one of the leading causes of preventable blindness among children worldwide — with India accounting for a significant portion of cases.

Modern Causes: The Irony of Plenty

It’s ironic — Vitamin A deficiency was once associated with poverty and food scarcity. Today, it’s reappearing among those with plenty of food, but poor dietary diversity.
Modern diets high in processed snacks and low in fresh vegetables, dairy, and organ meats have stripped away key nutrients.

Other risk factors include:

• Low-fat diets: Vitamin A is fat-soluble, so your body needs dietary fat to absorb it.
• Digestive disorders: Conditions like celiac disease, Crohn’s, or liver disease interfere with absorption.
• Post-surgery malabsorption: Bariatric and intestinal surgeries can reduce nutrient uptake.

Natural Sources of Vitamin A

Vitamin A exists in two main forms:

1. Preformed Vitamin A (Retinol): Found in animal-based foods — liver, eggs, dairy, fish oil.
2. Provitamin A (Beta-Carotene): Found in plant sources — carrots, spinach, pumpkin, sweet potatoes, and dark leafy greens.

Daily Needs:

• Adult men: ~900 µg (RAE)
• Adult women: ~700 µg (RAE)
• Children: 300–600 µg (RAE)

Including even a few servings of these foods weekly can prevent deficiency:

• Egg yolks — easy to digest and rich in retinol
• Liver (especially cod and chicken) — the most concentrated source
• Carrots and pumpkins — rich in beta-carotene, especially when cooked with ghee or oil
• Spinach, moringa leaves, and amaranth — local, affordable superfoods

The Public Health Perspective: Women and Children at Risk

Vitamin A deficiency disproportionately affects women of reproductive age and young children in India and across Southeast Asia.

During pregnancy and breastfeeding, women’s Vitamin A demands increase — but dietary intake often doesn’t. The result: infants born with lower liver Vitamin A reserves, increasing the risk of early-life blindness and infections.

Public health initiatives like India’s National Vitamin A Prophylaxis Programme (NVAPP) have helped reduce severe deficiency in rural areas, yet urban diets are creating a new form of risk — subclinical deficiency. These are mild, often unrecognized cases that can still weaken immunity and slow growth in children.

Supplements or Food — What Works Better?

While Vitamin A capsules are prescribed in specific deficiency cases, food-based correction is safer and more sustainable. Over-supplementation can cause toxicity (hypervitaminosis A) with symptoms like nausea, dizziness, and even liver damage.

The golden rule:

“Fortify with food first, supplement only when prescribed.”

Prevention and Eye Care Tips

1. Include a colorful plate — greens, yellows, and oranges daily.
2. Cook vegetables with healthy fats like coconut oil or ghee for better absorption.
3. Get periodic eye checkups, especially for children and pregnant women.
4. Avoid crash diets that eliminate fats or dairy.
5. Encourage children to play outdoors — sunlight supports overall eye health.

A Clear Vision for the Future

Night blindness might sound like a relic from the past, but it’s quietly returning through the cracks of modern living.

In a world of endless options, we’ve drifted away from nutrient balance. A humble carrot, a spoon of ghee, or a serving of greens can do more for your eyesight than the latest eye drops or supplements.

Because sometimes, the light we need begins with what’s on our plate.

References:

1. World Health Organization (WHO). Global prevalence of Vitamin A deficiency and night blindness, 2023.
2. West KP Jr. Vitamin A deficiency disorders in 2020: shifting patterns and public health responses. Am J Clin Nutr. 2020;112(2):394–398.
3. Tanumihardjo SA. Vitamin A: Biomarkers of nutrition for development. Am J Clin Nutr. 2016;104(Suppl 3):920S–925S.
4. Sommer A, Vyas KS. A global clinical view on Vitamin A deficiency and blindness prevention. Lancet. 2021;397(10276):104–106.
5. National Institute of Nutrition, ICMR. Dietary Guidelines for Indians, 2020.