Even with assistance such as Night Vision Goggles, one can get Spatial D'd. Spatial D problems in the sense of challenges, not necessarily a problem with the system itself. A good analogy would be taking two paper towel tubes and looking through them, in order to get an idea of field-of-view challenges. With NVGs, everything takes on a green hue, and lights on the ground may or may not differentiate in brightness and intensity, depending on their location, their number, and their concentration. So it's easy to, if you're flying purely visual, mistake stars in the sky for ground lighting and vice versa. That's why items like NVGs aren't said to "turn night into day" since you still need to monitor, analyze and cross-check your flight instruments.
Real world example: A little over seven years ago back in the A-10, I was flying a night flight to the bombing range. Low illumination and no moon (read: pretty damn dark). Coming off of a 45 degree dive-bomb pass, I was climbing through 35 degrees nose high and 20 degrees right bank and looking out the top right side of the canopy to try and spot my wingman in order to facilitate a visual pickup and thus, a quick altitude block-swap so he could begin his bomb pass from the "low block", or lower altitude block that I was currently in (commonly known as the "shooter block", with the high block being the "cover block" separated by 1000' or more.) Primarily, you use procedural deconfliction in the sense of differing headings and opening air-air TACAN (both jets going away from each other) and swap altitude blocks once about 2 miles and growing is reached. However, block swaps can be expedited if one or both jets have a visual on the other. So as I'm looking out my canopy, I'm pulling the jet back to the horizon purely by visual at about 100 degrees bank from 30 degrees nose high and coming down. I spot my wingman and begin radioing instructions to him while still flying the jet to level flight. For some reason, as the jet approached the horizon, still in 110 degrees bank, I kept padlocked (eyes on) my wingman while subconciously leveling the plane to the horizon and rolling out. But the Gs didn't feel right and the jet kept wanting to climb, forcing me to keep trimming nose-down trim. After about the third time of this unusual aircraft behavior and odd feeling Gs, I stopped looking at the other jet and looked ahead, seeing ground lights and the black sky above the horizon. I crosschecked into the cockpit to the ADI to find the grey on top and the white underneath, and the HUD pitch ladders with the broken lines on top (the HUD has pitch ladders in 5 degree increments with all the bars above the horizon solid and those below the horizon broken-lined....instant SA builder/helper). It took a few seconds to register that the jet was actually level-inverted, and the nose was trying to "fall through" the horizon, creating the odd feel of weightlessness to -1 G, and necessitating the second nature application of nose-down trim (to keep the nose "up" to the horizon). I quickly rolled 180 degrees and back to level upright flight, and took a minute to catch a breather and unscrew the situation.
This in an example of how even NVG flying can bite you if you get complacent for any amount of time, or task saturate yourself and end up dropping out/misprioritizing cross-checks. It can and does happen to the best of the best. When that happens, you've got to be able to (figuratively) throttle-back and assess, then do whatever's necessary to unscrew the situation, and un-tumbleweed yourself quick, lest you end up a smoking hole in the ground.
Whats funny is that earlier in that week, I'd heard this exchange during night air-air refueling. I was meeting a KC-135 tanker at AR-647 (south of KCGZ). The tanker was in and out of clouds/rain to where you got the "rush" effect of the WX going past the two of you. With NVGs off, you couldn't see when the tanker was going to enter the WX and it takes you by surprise.
Very good potential for Spatial D
The flight ahead of me, I heard this over the radio from the fighter on the boom ahead of me...........
Gunhog11: "Grizzley (the KC-135), any chance we can roll-out of this turn and AR straight tonight, it's getting a little disconcerting out here..."
Grizzley 21: "We're straight and level, sir."
Gunhog11: (somewhat suprised) "Ummm, Roger."