With daylight saving time coming to an end in early November, darkness will descend early each day — a change those with night vision challenges often dread.
Dr. Robert Null, glaucoma and cataract specialist for Wolfe Eye Clinic in Iowa City, says he sees two kinds of night-related vision problems more than any others.
“One is difficulty with vision at dusk time, like when they’re driving into the sunset in particular. At dusk, people oftentimes describe a lot of glare. It’s like looking through frosted glass or a dirty windshield,” Null said. “A number of different things can cause that. In patients who are about 50 years plus, it could be the start of cataracts. It’s one of the early symptoms people describe. When lights are shining in the eyes, a lot of glare can be generated, and that can be pretty visually disabling, actually. It’s one of the tests we do when determining whether a patient is ready for cataract surgery or not.”
Cataracts aren’t the only potential cause, however.
“Sometimes dry eye can actually cause that as well,” Null said. “Again, it’s a similar sensation to looking through a dirty windshield. You can imagine if you don’t have enough tear film on the surface of the eye, or if there’s debris in the tear film, or if it’s irregular, it’s like looking through oily water.”
A different problem arises once the sun is fully down.
“The other phenomena I see people describe a lot is that at nighttime lights do not seem bright enough. And that actually can be caused by cataracts as well, at least when you’re in the population of about 50-plus.”
This, of course, can make driving very difficult.
“Sometimes people will notice that they can’t see things very clearly and they have to turn their headlights up a little bit brighter or go to their high beams to see. Often, they have to look to the side of the road to see the lines painted there to orient them to where they are.”
Null suggested that the problem isn’t always in the patient’s eyes. Sometimes, the cause of the problem is in the cars on the road after dark.
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“A lot of times it can just be oncoming headlights in general. I feel like the car manufacturers are making brighter and brighter headlights nowadays,” he said. “The bright blue ones that you see every once in a while, in particular, I hear people complain about those more than anything else. And that doesn’t necessarily mean that you have eye problems. It’s just not always easy to see at night.”
Some people turn to night driving glasses for help when they notice vision challenges after dark, but Null is cautious about recommending them.
“Sometimes, if there’s a glare component, some products can be helpful. You have to look at them on an individual basis,’ he said. “They’re not something I routinely recommend for patients because I feel they’re a dime a dozen and evaluating them on a scientific basis is not always the easiest thing to do. But in terms of advocating for reducing glare, potentially they can be helpful for that. It’s the same principle as polarized sunglasses, but with much less intense of a lens.”
Null encourages everyone to have regular eye exams to identity potential issues early.
“You go to the doctor every year for a physical,” he said. “Get your eyes looked at once a year, too, especially if you feel like something’s not the way it should be.”