Understanding how vision issues can affect night driving and how to address them (2024)

Christine BryantTimes correspondent

Driving at night can transform familiar roads into stretches of unfamiliardarkness.

These challenges are compounded by age-related vision changes, which can further diminish confidence behind the wheel. Research shows nearly 62% of drivers feel less confident driving at night compared to during the day.

As individuals age, they may increasingly question how their changing vision will affect their ability to navigate the road ahead.

What’s behind the struggle to see at night?

“One of the main factors of aging that can affect most drivers is presbyopia, which is nearsightedness,” said Jolene Gelarden, a post-acute nurse practitioner at Powers Health’s Hartsfield Village. “The average person might begin to notice this typical worsening of near vision starting around the age of 40.”

Presbyopia is a common age-related condition in which the eye's lens gradually loses flexibility, making it difficult to focus on close objects.

Around 60, the human eye may require nearly three times more light to see in comparison to age 20, Gelarden says.

“The normal decline in vision makes driving at night more difficult for seniors,” she said.

Another change in the lens is the development of cataracts, which is the clouding of the lens that generally begins around 50, says Dr. Emily Mangiaracina, an optometrist at the Crown Point NorthShore Health Center. More than half of people older than 80 have cataracts or have had surgery to remove them.

“Imagine looking through a dirty windshield that can never be cleaned,” she said. “That’s how many of my patients describe their vision. There are numerous types of cataracts and the majority of them cause glare at night from lights. That’s why night vision and driving become increasingly difficult.”

Side effects from medications can also cause vision changes, Gelarden says.

“It is a good idea to discuss this with your health-care providers if you suspect vision changes are due to your medications,” she said.

Then there's night blindness.

Though it's a common term used to describe having difficulty seeing at night, night blindness is its own condition. Known as nyctalopia, this condition occurs when someone has extreme difficulty seeing at night.

Medical studies estimate that around 1 in 7,000 to 10,000 people in the United States have night blindness.

“This condition is the inability to see in dim light or at night,” said Dr. Maria Brown, a family medicine and geriatric medicine physician with Franciscan Physician Network’s Coolspring Health Center in Michigan City. “In most cases it causes a halo effect or glares around lights, which makes it difficult to see and drive.”

Several conditions can lead to nyctalopia, from a vitamin A deficiency to cataracts. One of the most common medical causes of night blindness is the genetic disease retinitis pigmentosa, a progressive degeneration of the retina.

Genetic diseases that lead to nyctalopia are more difficult to treat. Brown says seeing an ophthalmologist for a comprehensive eye exam is key to diagnosing an eye condition.

“An ophthalmologist will determine the treatment to correct vision, when necessary,” Brown said.

Can anything be done to improve night vision?

While the hardening of the lens is inevitable, spending less time on the computer or other electronics may help delay the need for reading glasses, Mangiaracina says.

Keeping the body healthy can also keep the eyes healthy, she says.

“A yearly physical with your primary care physician and a yearly comprehensive eye exam with your optometrist or ophthalmologist are important to keep your body and your eyes in tip top shape,” Mangiaracina said.

As for cataracts, they're often inevitable, she said.

“Generally speaking, spending less time in prolonged direct UV exposure can help delay onset,” Mangiaracina said.

Once a cataract becomes so large where glasses no longer improve vision or when a person’s quality of life is diminished by poor vision, cataract surgery may be necessary.

“Removing a cataract is like getting your dirty windshield cleaned,” Mangiaracina said.