Clinical Review Lesson of the week

Fear of the dark in children: is stationary night blindness the cause?

BMJ 2003; 326 doi: (Published 25 January 2003) Cite this as: BMJ 2003;326:211

This article has a correction. Please see:

  1. Sikander S Sidiki, specialist registrara,
  2. Ruth Hamilton (, senior medical physicistb,
  3. Gordon N Dutton, consultant ophthalmologistc
  1. a Tennent Institute of Ophthalmology, Gartnavel General Hospital, Glasgow G12 0YN
  2. b Department of Clinical Physics, Yorkhill NHS Trust, Glasgow G3 8SJ
  3. c Ophthalmology Department
  1. Correspondence to: Ruth Hamilton
  • Accepted 21 March 2002

Fear of the dark in children may have a pathological basis

Fear of the dark is a common complaint of pre-teenage children. 1 2 It should not be confused with night terrors or panics, in which a child becomes acutely agitated and terror-struck at night, appearing to be awake while in fact asleep and unable to be woken. 3 4 In contrast, fear of the dark can be experienced by the conscious child in dimly lit or dark conditions. When such fear is excessive it is often attributed to attention seeking behaviour or assumed to be an irrational fear that will abate with time.

Most people can see a little in very dim lighting conditions after a short period of adaptation. However, a child with no visual problem obvious to the parents and who can see normally in well lit conditions can present as being unable to see at all in the dark even after a period for adaptation. In a child who cannot yet talk this may simply appear as fear of the dark. We describe two patients with congenital stationary night blindness, a diagnosis which may be missed without appropriate history taking from the parents, particularly if there is no family history of visual problems.

Case 1

A 3 year old girl had been frightened of the dark from an early age. She had complained to her parents of not being able to see when the bedroom lights were turned off, prompting the natural response, “Wait until your eyes adjust.” She would persist …

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