Help patients see the light when driving at night

Nov. 4, 2018, marks the official end of Daylight Saving Time. But by now drivers have already noticed the shrinking sunlight during their commutes.

The shorter daylight hours can exacerbate existing eye conditions and expose undiagnosed vision problems. Although the days have been getting shorter for months, the end of daylight saving time presents an opportunity for doctors of optometry to reinforce the essentialness of eye care.

"One of the No. 1 complaints from patients that we have in our offices is difficulty driving at night," says Sue Lowe, O.D., chair of the AOA's Health Promotions Committee.

That's what prompted the committee to team up with Karl Citek, O.D., Ph.D., member of the AOA Commission on Ophthalmic Standards, on a tool doctors can use to educate patients on the hazards of driving at night—and what patients can do about them—"Vision Tips for Safe Driving at Night."

Night vision

As the days grow shorter, patients report distracting glares, not only from the sun, but also from the headlights (high-intensity discharge and light-emitting diode lamps) of oncoming cars. Patients with glaucoma and cataracts are especially sensitive. A possible diagnosis is night myopia. 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. Then there are environmental factors, brought on by heaters (in office settings or vehicles), and stronger, outdoor wind currents that can cause low humidity and lead to dry eye.

Turning our clocks back means that commuters will find themselves driving to and from work in less light. Seeing their eye doctor is encouraged when patients have concerns about driving safely at night or in challenging conditions.

"Many patients, especially those with early cataracts, complain of difficulty seeing in low light or dim conditions, such as driving at night or in foggy, stormy weather," Dr. Citek says. "Unfortunately, a new pair of glasses will not bring relief, especially not ones that are tinted.

"Doctors of optometry can counsel these patients about viable options, including referral for surgery and strategies to use prior to surgery," he says. "For all patients, knowing what to do in bad weather or when an oncoming vehicle has very bright headlights is equally important," he adds.

The AOA fact sheet offers more than 20 tips for patients so they can navigate the roadways more safely, including: 

• Never look directly at an oncoming vehicle, regardless of the type of headlights it has.
• Clean a dirty, streaked or fogged windshield, outside and inside, to reduce glare and increase visibility.
• Replace windshield wipers as necessary.
• Turn off inside lights and turn down dashboard lights to the minimum level to cut down on glare from lights that you are not looking at or toward.
• Consider prescription eyeglass lenses with anti-reflection coating to minimize distracting light from car dashboards, street lamps and other vehicles.

"These suggestions and recommendations are integrated with research and successful recommendations and tips," Dr. Lowe says. "We hope to provide the optometrist with communication points for their patients to improve their driving at night as well as confirming their eyes are healthy and they have up-to-date vision correction.

"Also, with the new headlights as well as the new street lights, we wanted to make the public and doctors aware of some of the lighting changes in cities and on the cars themselves that have taken place over the past 10 years," she adds. "No other health profession knows more about light than optometry."

AOA resources

View the Night Vision fact sheet.
View a case study on vision and driving on the AOA Ethics Forum.