Answers by Mitchell Gossman, MD, an ophthalmologist at Eye Associates of Central Minnesota, located in St. Cloud
What is causing the glare I’m experiencing?
First, the term “glare” needs to be clarified and defined. Ophthalmologists use the term “glare” to mean difficulty with vision associated with bright light. The symptom ophthalmologists call “photophobia,” also known as “light sensitivity,” has to do with eye discomfort associated with bright light. Discomfort with bright light can be normal, such as driving into the glare of the sun, which is why car visors and sunglasses exist. The issue of uncomfortable light sensitivity will be left to a future article. It is possible to have both glare and photophobia.
“Glare” means that a bright light source is interfering with vision. This can cause some of the following problems:
1. Difficulty with driving at night because bright light sources, such as car headlights and street lights, have haloes or spikes around them. These complaints are becoming more common as cars and streetlights are being converted to the higher intensity LED lights.
2. Difficulty with driving at night due to bright car headlights or street lights causing a blinding dazzle, i.e. “white-out.”
3. Difficulty when driving on a sunny day as the bright sun enters the passenger compartment and shines directly on the eyes, causing a “white-out” of vision.
When a bright light source, such as the sun or car headlights, enters the eye, it should be focused to a sharp image on the retina. If there is something cloudy in the cornea or the natural lens of the eye, the light can be “scattered” so the entire retina is flooded by the light rather than being focused to a point. This can cause the sun or headlights to temporarily cause a “white-out,” or profoundly blurry vision which is at least annoying and at worst dangerous.
The same issue can cause the light to be seen as a light surrounded by haloes or spikes, as if the light is in a fog or dirty and streaky windshield.
What can be done about this?
As always, because it’s not possible for you to examine your own eyes for the source of the trouble, you should schedule a complete eye exam. Some of the more common causes of this problem are cataracts, corneal disease and a need for corrective lenses, i.e. glasses. Even scratched, dirty, or defective glasses can cause this glare.
If the cause of the trouble is cataracts, and the symptoms are bothersome enough, cataract surgery can be performed.
It must be said also that some people just have trouble driving at night, even when the eye exam is completely normal. The cause is not always knowable, but it tends to be a worse issue when driving in the rain. This is not always treatable, but sometimes a special pair of glasses with a power adjustment specifically for night driving will help. If cataract surgery is performed perfectly it is also possible for some glare symptoms to persist due to unknown causes or the limitations of lens implant technology.
Find out more
The bottom line is, if you are having trouble with glare, haloes, or blurry vision, especially with bright sun or headlights, schedule an eye exam, and come up with a plan to deal with this in the safest, most effective manner.
Mitchell Gossman, MD., and Andrea Joplin, MD., are ophthalmologists at Eye Associates of Central Minnesota in St. Cloud, Minnesota, and see patients from all over Central Minnesota and the St. Cloud area. They accept new patients, and appointments may be made at 320-774-3789.
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