Night driving trouble after 40: Causes and treatments

Your optician can check your vision and overall eye health, and offer some solutions to the night vision problems that become more common after the age of 40.

Many factors can affect night vision, and there are several simple steps you can take to make it safer to hit the road after dark.

Why does night driving get more challenging as you age?

One of the main factors that affect almost all drivers with age is presbyopia. Most people notice this typical worsening of near vision starting around 40.

If you have to hold your phone at arm’s length or wear reading glasses to decipher the print on a prescription bottle or recipe card, you’ve got plenty of company. Around the world, almost 2 billion people have presbyopia, according to a study published in Ophthalmology. Presbyopia isn’t the only reason it gets more challenging to drive at night as you get older. Other eye-related changes can make night driving a challenge. For example:

• Your pupils get smaller. Less light gets into your eyes as your pupils shrink with age, and this affects the sharpness of your vision.
• Your retinas change. Older adults have fewer rod cells — light receptors in the retina responsible for the black-and-white vision that’s essential for night driving.

How do these eye issues affect you when you get behind the wheel after dark? First, you may not be able to see the dashboard as clearly as you can in the daytime. You may get temporarily “blinded” by the glare of oncoming headlights, and it can take time for your eyes to adjust back to total darkness after that car goes by. You also may find yourself struggling to read markers and road signs at a distance.

Other factors that affect night vision as you age

In addition to these normal age-related eye changes, people over 40 may be more likely to develop the following conditions that can cause night blindness (difficulty seeing at night):

• Cataracts – One of the first symptoms of cataracts is a loss of contrast sensitivity, which you may notice first at night. While cataracts may start around age 40, they may not affect your vision until after 60. About 65.2 million people have cataracts worldwide, according to the World Health Organization.
• Glaucoma – This condition can impact your ability to drive at any time of day because of the way it narrows your field of vision. Glaucoma also can make you more sensitive to glare, and some glaucoma medications may make that problem even worse. Globally, more than 3.5% of people aged 40 to 80 have glaucoma.
• Fuch’s dystrophy – This eye disease can cause night vision problems, such as sensitivity to glare and halos around lights. Fuch’s corneal dystrophy mostly affects people in their 50s or older.
• Vitamin deficiency – Vitamin A deficiency can cause night blindness, making it difficult to drive safely after dark. It is considered a public health problem in half of all countries.

Whether your eyes are just getting a little older or you have a specific eye issue, there are steps you can take to mitigate night vision problems.

Can I get night blindness treatment?

If you’ve spotted the first signs of presbyopia or you get nervous driving at night, contact your optician and make an appointment for a comprehensive eye exam.

Your optician will check your vision, examine your eyes and ask questions about your difficulty driving at night. Specific opticians can test your night vision using special instruments.

If you experience night blindness, especially after age 40, you have options. While treatment will depend on your specific situation, here are some steps you can take:

1.     Get up-to-date glasses or contacts. First, make sure your prescription is current. If you have presbyopia, progressive lenses or multifocal contacts can help your night vision. The advantage is that they correct near, intermediate and distance vision, bringing your car’s instrument panel and faraway road signs into focus.

2.    Consider a lens solution with an anti-glare coating. If you wear glasses, an anti-glare coating (also called anti-reflective coating or AR coating) can reduce the amount of light reflected off of the lenses. Especially helpful at night when you may face glare from oncoming headlights or streetlights reflected on wet roads.

3.    Seek treatment for other conditions. Talk to your eye care professional about whether an eye condition may be contributing to your night vision issues. If you have cataracts, for example, your optician may recommend cataract surgery. If your glaucoma medication causes your problem, your optician may be able to change your prescription.

4.    Look into driving glasses. What are night driving glasses? They’re a lens solution that contains a specific lens coating that reduces more reflections at night. 

Avoid non-prescription glasses that typically have yellow-tinted lenses. A recent night driving study found no benefit to non-prescription night driving glasses. 

The bottom line? If you worry about driving at night, your optician can help make sure it’s safe for you to slide behind the wheel after the sun goes down.