Don't leave patients in the dark about night driving

With the days already growing shorter—and the rollback of daylight saving time (DST) around the corner—doctors of optometry can access AOA resources that can signal to patients their vision might be affected while driving in the evening.

DST ends Nov. 3 and the change to standard time can exacerbate existing eye conditions and expose undiagnosed vision problems, says Sue Lowe, O.D., chair of the AOA Health Promotions Committee, who practices in Wyoming.

AOA resources include:

• "Vision Tips for Safe Driving at Night" fact sheet.
• "A Driver's Guide to Vision" pamphlet.
• Ethics Forum case study, "Vision and Driving," offers legal and ethical considerations when talking to patients about driving.

An opportunity for doctors of optometry

According to the National Safety Council, Americans do only one quarter of their driving at night, yet 50% of traffic deaths occur then.

"When Daylight Saving Time ends—for 2019, that's 2 a.m. Sunday, Nov. 3—many people will find themselves spending more time driving in the dark," says the National Safety Council. "Depth perception, color recognition and peripheral vision can be compromised in the dark, and the glare of headlights from an oncoming vehicle can temporarily blind a driver.

Says Dr. Lowe: "One of the No. 1 complaints from patients that we have in our offices is difficulty driving at night."

Some patients might experience depression or seasonal affective disorder (SAD) and others report the distracting glare of oncoming headlights. Patients with glaucoma and cataracts are especially sensitive, Dr. Lowe adds. A possible diagnosis is night myopia, Dr. Lowe says. At night, the pupil's size increases, allowing for more aberrations from uncorrected prescriptions (for glasses and/or contact lenses) due to unfocused or scattered light rays.

"Have you seen old, wavy window panes?" she says. "The distortions or aberrations are similar to that." Then there are environmental factors, brought on by blowing heaters (in your office or car) and stronger, outdoor wind currents that can cause low humidity and lead to dry eye, Dr. Lowe says.

Dr. Lowe suggests doctors of optometry:

• Ask patients about how they are making the adjustment to seasonal conditions.
• Consider light therapy boxes for increasing patients' exposure to light, anti-reflective coating for glasses and contacts to reduce glare, or artificial tears to treat dry eye.
• Provide a comprehensive eye examination to either diagnose or rule out ocular health or vision conditions.