Driving at night: Solutions for improving your night vision

Driving at night can be hazardous when you have pre-existing conditions that impair your vision. In the winter, it is particularly important to seek treatment for vision problems since shorter days mean leaving work after dark coupled with icy roads which can lead to danger for drivers. Here’s why you should consider speaking with your eye doctor about potential solutions and surgical options to improve your vision that can make you a safer driver at nighttime.

Driving dangers:

Simply put, our pupils dilate in the dark which can lead to a myriad of vision issues while driving at nighttime. Dilated pupils enhance myopia (nearsightedness) and astigmatism which can make it difficult to see road hazards such as road signs, pedestrians, and animals. Also, oncoming headlight glare can become burdensome in patients who have developed cataracts or for someone who does not have an accurate prescription in their glasses or contacts. This can make it difficult and scary to drive at nighttime especially in areas that are poorly lit.

Types of vision impairment:

  • Myopia (nearsightedness): Results in overall decreased vision at nighttime as well as difficulty identifying and avoiding hazards. You run a high risk of causing injury to yourself and others who share the road with you if you’re driving with this condition, particularly during the night.
  • Astigmatism (abnormal curvature of eye): Results in streaky or blurred lights, which can negatively impact how you see car headlights and street lights. You will likely experience increased glare, halos, or streaks, which can cause you to squint.
  • Presbyopia (farsightedness): Results in an inability to see your dashboard/GPS, which can prevent you from being able to safely monitor your speed, see the directions on the GPS or even ensure your headlights are on and working properly.
  • Nyctalopia (night blindness): Can be caused by cataracts, glaucoma, vitamin deficiencies, and genetically inherited eye diseases. It heavily limits the capabilities of someone to see at nighttime and patients with this diagnosis should completely avoid driving at night.


The first step to improve vision in low light conditions is to have an up-to-date eye exam with your ophthalmologist or optometrist. For most people, making sure you have an accurate prescription and updating your glasses and contacts can significantly improve vision at night. Your eye doctor will also screen you for more serious conditions such as cataracts, glaucoma, and other vision-threatening eye diseases.

There are a wide variety of procedures available to correct the above vision issues that can make you a safer driver at nighttime. Laser vision correction such as Laser-assisted in situ Keratomileusis (LASIK) or Photo-Refractive Keratectomy (PRK) can correct myopia and astigmatism. These are long-term, safe, and effective procedures that can fully correct your vision so that you can see clearly at night without the need for glasses and contacts. It is fairly easy to determine if one of these procedures is right for you. If you are not eligible for laser vision correction surgery or are interested in different options, there are alternatives available to you.

A safe and effective alternative to laser vision correction is the Implantable Collamer Lens (ICL) surgery. This procedure treats nearsightedness and astigmatism, and essentially involves surgically implanting a permanent contact lens into the eye. This can achieve vision results that are equal to LASIK without having to permanently alter the structure of the eye. This is a great option for patients who have been told that they are not LASIK candidates or have too high of a prescription to safely undergo LASIK.

Refractive Lens Exchange (RLE) is a good choice for anyone over the age of 45 with nearsightedness, farsightedness, or astigmatism and minimal cataract formation who require reading glasses to see up close. This procedure can restore a full range of vision in patients so that they no longer need glasses to see far away or up close. An added plus to this surgery is that it lasts for a lifetime and those who undergo it will never form a cataract.

Finally, Refractive Cataract Surgery is a potential choice for anyone suffering from glare, halos, and decreased vision at night time due to cataracts. This procedure is similar to traditional cataract surgery but comes with the added bonus of simultaneously correcting nearsightedness, farsightedness, or astigmatism by correcting all of your prescription at the time of cataract surgery.

For more information or to schedule a consultation, please visit please contact Dr. Salisbury today at https://salisbury-vision.com/contact/.

Eye rubbing and Keratoconus

Keratoconus is a corneal disease that is characterized by corneal thinning and steepening that leads to an abnormally shaped corneal surface. This is a poorly understood condition but can lead to an increase in myopia (nearsightedness) and astigmatism if there is progression. The exact cause is unknown, but there is a genetic link since around 1/10 of people who have keratoconus have a parent with the same condition. There are also recent studies that show eye rubbing can trigger or worsen symptoms in someone with underlying keratoconus. It can appear between the ages of 10 and 25, usually progressing slowly until the age of 40.

Eye rubbing’s effects on keratoconus:

Studies have shown that there appears to be a link between eye rubbing and keratoconus. The repetitive mechanical trauma from eye rubbing can weaken the cornea, increasing the progression of keratoconus.  An individual with a long habit of rubbing their eyes can develop keratoconus in the rubbed eye, both eyes equally or in both eyes unevenly. There is a high association between people with allergies and keratoconus which can be explained by the fact that many people with chronic allergies rub their eyes. Eye rubbing causes keratocyte thinning to varying severities, depending on the intensity and time spent rubbing.

What can I do to be screened for and prevent keratoconus?

The most important step if you suspect you may be at risk for keratoconus is to have regular eye exams. Risk factors for developing keratoconus include positive family history, chronic allergies, eye rubbing, and Down Syndrome. Symptoms of keratoconus include blurry vision with or without glasses/contacts, increasing myopia (nearsightedness), and increasing astigmatism. Scheduling appointments with your eye doctor and informing them of any of the above risk factors or symptoms will allow them to properly screen you for this condition.

Try to avoid rubbing your eyes as much as possible. If you feel intense itchiness or dryness in your eyes which causes you to rub them, try artificial tear drops, allergy eye drops, or oral allergy medications and talk to your doctor about potential solutions for your symptoms. Stay aware of changes to your vision, especially if it begins to progressively decline, and update your doctor of any new changes or symptoms.

Treatment options for keratoconus:

Slowing disease progression and providing optimal vision correction are the primary goals of treatment for keratoconus. Nearsightedness and astigmatism are generally treated with glasses and specialized contacts in the early stages, but as eyesight continues to worsen, other options need to be considered.

One popular treatment option for the early/moderate stages of keratoconus is Corneal Cross-Linking surgery. During the procedure, your eye doctor uses a combination of Riboflovan eye drops and ultraviolet (UV) light to strengthen the cornea by creating extra bonds that act as support beams between the collagen fibers throughout the cornea. This process can prevent the progression of keratoconus, but not reverse any existing damage to the vision that has already been done, so it is important that your eye doctor screens you for this disease in order to diagnose it at an early stage.

If left untreated, keratoconus can eventually deteriorate the vision to a point where glasses and contacts are unable to provide adequate vision. At this point, the only option left to restore vision is Cornea Surgery. Penetrating keratoplasty (PKP) is a corneal transplant procedure that requires the removal of the entire diseased central cornea and replacing it with a new one by suturing a donor cornea in place. The healing time lasts from months to years and patients must use steroid eye drops indefinitely to prevent rejection.

As a whole, it is integral that keratoconus is detected and treated as early as possible in order to prevent having to undergo such an invasive procedure as a cornea transplant. Eye rubbing can trigger and cause the progression of this condition. There is a range of treatment options for the disease, so ask your eye doctor about them today!

For more information, please contact Dr. Salisbury at https://salisbury-vision.com/contact/.