Retinitis pigmentosa is an inherited condition which involves both eyes. If it starts in one eye, the other eye usually develops the same condition in a number of years. Most cases are familial, inherited in a variety of ways, including dominant, recessive, and sex-linked recessive. Some cases are sporadic and lack a family history of the disease. A thorough genetic pedigree, often with the aid of a genetic counselor, is essential in determining risk of future generations acquiring the disease.

Retinitis pigmentosa is usually diagnosed during the teenage years but may be present at birth. The latter congenital type is usually fairly stable and nonprogressive. Cases that are diagnosed later in life are often milder and may progress more slowly.

RP is sometimes associated with other systemic illnesses. Usher syndrome, characterized by retinitis pigmentosa and neural hearing loss, is the most common cause of deaf-blindness in the United States. The hearing loss usually is diagnosed earlier than the eye changes.