Night blindness is mostly due to abnormalities in the retinal pigment epithelial cells, because when these cells are abnormal, it leads to abnormalities in the rod cells, which sometimes leads to night blindness. This is because rod cells are responsible for seeing in low light, proving that this refractive system’s weakness is akin to a camera’s film being damaged. In the case of performing surgery for nearsightedness, it is primarily because there's an issue with the eye’s refractive system, similar to having a damaged camera lens. While a damaged lens can be repaired, if the film is faulty, even a perfectly repaired lens won't improve the camera's imaging function. Thus, night blindness primarily involves the retina, whereas surgery for nearsightedness mainly involves the lens and cornea. If the retina's condition is poor, then vision improvement from nearsightedness surgery will be limited because the effectiveness of such surgery relies on the pre-surgery vision achievable with glasses. If vision with glasses is inadequate, the surgical outcomes tend to be suboptimal. Generally, we do not recommend laser surgery for patients with night blindness.