Q: While I still enjoy driving, of late I find myself having more trouble seeing the details of the road after dark. I am over 60 and wonder if this is “normal” or a sign of something more serious?
A: Yours is a very common question, and could have several possible causes. However, by far the most common reason for this change is your night vision is natural and unavoidable. As the birthdays roll by, our natural internal “crystalline lens” inside our eye becomes less and less clear. Gradually our lens gets hazier, cloudier, and even discolored…..allowing less light and crisp vision to reach our retina. This is the normal progression leading to cataracts.
This natural change can usually be managed or improved with a change in your glasses. First, realize that we all become slightly more nearsighted after dark, as our pupils enlarge or dilate a little. We can prescribe “ night driving glasses” that accurately correct your true night vision, and commonly we have the lab include a light amber tint in the lenses also. Our eyes actually see better in the dark with yellowish or amber lighting, so this improves driving vision for most of us. We can specify the best and most complete glare reduction lenses also to help cut down on glare from oncoming headlights, making it easier to see the edge of the road and anything unexpected in the highway.
Of course, there are other, more worrisome causes of decreased night vision. It turns our that our “dark adaptation” vision is reduced in the early stages of macular degeneration. Careful imagination and examination of the retina can diagnose this fairly common concern. Other less common causes can be disorders of the optic nerve, and corneal diseases.
Step one would be a thorough eye examination. If the eyeglasses changes look promising, I would advise caution and wisdom in who actually makes your glasses. These days, we find so often that online and big box stores make glasses with inaccurate prescriptions and/or inferior cheaper grade ophthalmic lenses. Eventually, if early cataracts are the cause, you will need surgery to replace the cloudy lenses with plastic intraocular lenses. However, that end result can be delayed many years with proper vision correction.