Out of the Dark: Managing Night Blindness

The struggles to see at night are real. You carry a flashlight every time you leave the house or enter a dark room. You grip the steering wheel and strain to see road signs or manage the glare of oncoming headlights when you drive after dark. You may decide not to go out at night, unless someone else offers to drive. Night blindness, which affects many Americans over 50, can be stressful and limiting for someone who once enjoyed the night life.

Credit: Getty

Sometimes aging can affect our lives through sensory disabilities, including our sight. In fact, the U.S. Census Bureau's 2020 American Community Survey reports that 6% of the 65-plus population that reported having a disability had some sort of vision difficulty. Night blindness is a part of that percentage, and many do not approach their eye doctors about it, thinking that it is likely irreversible.

"Nyctalopia (commonly referred to as night blindness) occurs when an individual has significant difficulty seeing outside at night or in dimly lit interior areas," says Dr. Robert C. Layman, president of the American Optometric Association (AOA). "As we get older, into our forties and beyond, it is normal to experience age-related vision changes which can progress over time. However, this is also the time in life when the risk for developing a number of eye and vision problems increases."

Night blindness could be a symptom of a larger problem, such as age-related macular degeneration and diabetic retinopathy, which are more common in this age group.

Some believe that night blindness is a hereditary condition, or that it is tied to a lighter eye color. Dr. Michelle Andreoli, clinical spokesperson for the American Academy of Ophthalmology (AAO) says there is limited scientific evidence to suggest that people with certain eye colors are more at risk for night blindness.

"There are some theories that people with light colored eyes may be better at driving at night compared to people with dark colored eyes; this is because people with light colored eyes have less pigment in the iris, which lets more light into the eye," she says.

Layman says that there is no research that suggests a connection of night blindness to eye color. However, genetics may be a factor in specific instances.

"Genetics may have a role to play with certain individuals, since night blindness can be a result of a genetic disorder such as retinitis pigmentosa," says Layman.

And the struggles to see at night could be a sign of other problems.

Having a hard time seeing at night could be a warning sign of an eye disease, which can become more common with age. Layman and Andreoli suggest that if you notice your vision is getting worse, you should schedule an eye exam to determine if there are any underlying conditions.

Some causes of night blindness:

• Cataracts: The lens of your eye is normally clear, but a cataract is a clouding of the lens. This cloudiness could impair your vision and interfere with driving.
• Glaucoma: Glaucoma is more common in older adults. High pressure in your eye can cause damage to the optic nerve, which is important for day and night vision.
• Macular degeneration: This is another eye disorder that occurs mainly in older adults. The macula of your eye is found in the retina, and it helps with clear vision. If the macula thins, your vision becomes blurred or your line of vision is diminished.
• Diabetes: Blurry or impaired vision can be a symptom of Type 2 diabetes, and this and other symptoms can be slow to develop.
• Vitamin A deficiency: Vitamin A, also known as retinol or retinoic acid, affects cell growth and vision among other things. If you have had gastrointestinal surgery, you may have trouble absorbing Vitamin A.
• Retinitis pigmentosa: Retinitis pigmentosa, or RP, is a group of diseases that are inherited. RP breaks down the photoreceptor cells of the retina that reflect light, causing a progressive vision loss. Those dealing with RP often have trouble adjusting to environments that switch from light to dark, such as entering a movie theater from bright outdoor light.

Are there remedies or treatments for night blindness? It depends.

"There are no home treatments or exercises that can improve night vision. Prompt medical treatment of any underlying conditions will preserve as much vision as possible," says Andreoli. "Some causes of night blindness can be easily treated with solutions such as eye drops or medications or various types of tinted lenses. Other diseases may require more complicated treatments. Your doctor can help figure out what's best for you."

Layman advises getting a thorough eye exam with a doctor of optometry who will conduct a series of tests to identify any signs of eye disease or vision problems. You may be asked to take a blood test to check glucose and Vitamin A levels.

"Your optometrist can detect more than 270 serious conditions ranging from diabetes to brain tumors, autoimmune diseases, glaucoma and even certain kinds of cancer. Many eye and vision problems have no obvious signs or symptoms, so you might not know a problem exists," says Layman. "Fortunately, many sight-threatening diseases can be cured or slowed with early diagnosis and treatment."

Although night blindness could be a symptom of serious eye conditions, some diseases that affect night vision might be prevented, says Layman.

He suggests incorporating these healthy lifestyle choices:

• Getting regular exercise.
• Eating foods that are rich in certain vitamins and nutrients, such as nuts, eggs, oranges, spinach, salmon and red meat. “Foods that are rich in vitamin A are typically orange including sweet potatoes, pumpkin, butternut squash, mangoes and carrots and will give your eyes a healthy boost," he says.
• Protecting eyes against harmful UV rays with quality sunglasses.
• Avoid or stop smoking. This contributes to macular degeneration and cataracts.

The American Academy of Ophthalmology recommends that adults over the age of 40 have an annual eye exam.

"The best way to prevent night blindness is to prioritize preventative eye health. Because vision loss from the eye diseases that cause night blindness are often preventable if caught early enough, getting your eyes checked regularly is critical in avoiding night blindness," says Andreoli.

Rosie Wolf Williams is a freelance writer whose work has appeared in USA Weekend, Woman's Day, AARP the Magazine and elsewhere. Read More