May is Healthy Vision Month, and as drivers, maintaining eye health is important to remain safe and competent behind the wheel.
One thing we must remember is that for all of us, our eyesight starts to wane as we age. And one way this impacts us is when we are driving at night.
There are several reasons why our eyes fail as we grow older, but one reason is due to our lenses — specifically, our ability to focus. The medical term for this condition is called dysfunctional lens syndrome (DLS), which is a kind of farsightedness.
The Eye Anatomy of DLS
So what is actually happening to the lens of your eye as you age?
“Inside our eye is a lens called the crystalline lens, and that lens changes over time. The lens is responsible for changing focus from far to close,” explains Lance Kugler, MD, an ophthalmologist and refractive eye surgeon who specializes in treating DLS.
Kugler states that it’s not entirely known why our eyes’ lenses start to fail as we age. But one prevailing theory is that our eye lenses become too big to be moved around and over time become immobile. Our lenses become cloudy because of protein and crystal deposits which form over time, eventually leading to the development of cataracts.
The Three Stages of DLS
There are three stages of DLS that you should be aware of, especially if you’re in your 40s or older.
The first stage begins around your mid-40s. This is the age when people start to need reading glasses. You can only start to read things clearly from far away. How this impacts night driving is that this is also the stage when your vision becomes blurry. You may find oncoming headlights or street lights to be bothersome.
The second stage of DLS occurs during your late 40s to mid-50s. During this stage, you’ll most likely really start to notice a difference in nighttime driving. Kugler explains the symptoms: “The lens starts to get a little yellow, night vision starts to fade, and you lose contrast sensitivity. So you lose the ability to detect differences in texture and color.” This makes it harder to see things on the road as you drive. And generally, at this age, you’ll find it harder to read in the dark.
The third stage of DLS happens during your mid-60s (age 65 and older) and involves developing a cataract in the eye. The lens has become yellowed and distorted enough that you won’t be able to see well at all. Also, with a more yellowed lens, color perception becomes affected.
Coping with Aging Eyes
Kugler suggests that if you’re concerned about nighttime driving at any age, you should first get a high-quality exam. This will ensure you get the right diagnosis.
“Fifty percent of the population before the age of 40 need glasses because we’re nearsighted,” he said. So for the rest of us, we typically don’t need glasses until we’re in our 40s and start developing DLS.
Dry Eye
Another eye condition which develops as we age and can affect our vision is dry eye. Dry eye simply means that your eyes aren’t producing enough quality tears. It can also be caused by several other factors including some medications and medical conditions.
Your eyes may not feel dry, but one of the symptoms of dry eye is having issues with night driving. Other symptoms include light sensitivity, feeling like something is in your eye, and watery eyes. Mayo Clinic lists several ways to help alleviate dry eye symptoms including:
Using a humidifier to add moisture into the air
Putting your computer screen below eye level so you don’t have to open your eyes as widely
Using artificial tears
Surgical Interventions
If you’re in your 40s and are starting to have trouble with night driving and blurred vision (stage 1 of DLS), Kugler suggests exploring LASIK eye surgery, which can correct farsightedness, nearsightedness, and astigmatism. This procedure uses a laser to help reshape the cornea.
If you’re in your mid-50s and are in stage 2 of DLS, another surgical procedure you’ll most likely need is a Refractive Lens Exchange (RLE). During this procedure, your crystalline lens is replaced with an artificial one. So not only will you be able to see more clearly without the need for reading glasses or contact lenses, but you will also prevent stage 3 of DLS (cataracts) from forming in your eyes.
If you get to stage 3 of DLS, which can occur during your 60s or older, then cataract surgery would be required, replacing the old crystalline lens with a new artificial lens.
Besides the eventual surgery you’ll need to replace your lens, Kugler says that the best way to keep your eyes healthy as you age is to take care of your general health.
Nighttime Driving Tips for Older Drivers
Beyond seeing an eye doctor, if you have issues with nighttime driving, here are some general driving tips you should consider:
Drive only on the roads that you’re familiar with.
Allow for extra travel time and drive more slowly and cautiously.
Keep your windshield, windows, and headlights clean to prevent additional blurriness and glare.
Refresh your driving skills with a driving course.
The American Optometric Association has other suggestions for older drivers: If you’re a driver over 40, you may not have to give up night driving just yet. Both DLS and dry eye are treatable conditions, so check with your eye doctor to see what treatment is right for you.
