This 19 year old myopic man first noticed reduced night vision and some constriction of his visual field at age 7 years. At that time, his best corrected visual acuity was completely normal.

The clinical features supporting the diagnosis of X-linked retinitis pigmentosa in this patient include: night blindness and constricted visual fields as his earliest symptoms; bone-spicule-like pigmentation and narrowed arterioles on fundus examination; loss of outer retinal structures on OCT; onset before age 20; and, a similarly affected maternal grandfather.