Vision, especially at night

How good is your vision, especially at night? It`s an important safety issue.
Many of us are at an age where our vision can have significantly deteriorated. And it`s like the paint on your car getting dull, it can happen so gradually you may not notice.
Eventually I realized my night vision was poor. Other boats heading home after NYE fireworks were faster and confident of their surroundings, but I was struggling to see boats,landmarks, etc. Attempts to improve vision by adjusting lens prescriptions were marginal. I had cataracts.
It was only after cataract surgery for lens implants I realized how poor my vision had been, 24/7. The surgery was miraculous. My vision was back for all purposes. And I could navigate confidently at night. It was not inexpensive, but so worth doing. The procedure is not too unpleasant, the inconvenience is nothing compared to the results.
That`s just my experience. No doubt there are other issues affecting vision, be it day or night, but as we get older cataract formation becomes likely and can seriously compromise your vision.
Do you you have a vision deficit, can you tell if you do, and is it reversible? If you do, is it affecting your safety as a skipper? How can you avoid an object in your path if you can`t see it? In Australia, often the first step is seeing an optometrist, an examination usually fully covered by Medicare.
I hope dhays and any other experts will contribute to and expand what I think is an safety important issue.

Navigating at night sometimes is less about night vision and more about a combination of skills.

Skills such as .....recognizing patterns that don't fit, such as distant lighting being blocked by something, using a spotlight as required, knowing what lies ahead navigation wise so your concentration is looking versus thinking about details, not staring at or for targets and using peripheral vision more and certainly using aids to identify things and distances.....

There were several of the tips we trained when searching at night on rescue cases....there are many more...search, searching at night.

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psneeld said:

Navigating at night sometimes is less about night vision and more about a combination of skills.

Skills such as .....recognizing patterns that don't fit, such as distant lighting being blocked by something, using a spotlight as required, knowing what lies ahead navigation wise so your concentration is looking versus thinking about details, not staring at or for targets and using peripheral vision more and certainly using aids to identify things and distances.....

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Doubtless that is correct. How you use your vision is important. But it still comes back to the quality of your vision. If your vision is impaired,even with the best skills you know to utilize your vision,there are things you may not see, well or at all. And there lies danger, unseen.

My night vision is way off from my earlier years, that's why the tips are all that more important.

Can't say what level of vision is the right amount to safely navigate at night, but at 62 I have no problem running portions of my local ICW at night at over 20 knots, avoiding unlit marks, buoys, crab pots, no wake zone buoys, boaters, etc...

....it is playing all those tricks and using the right tools that make it safe.

Any yes, there are times and areas I slow to a crawl when the prevailing conditions warrant.

After the USCG, I got to keep my skills up by running assistance Tow boats at night through tricky back waters.

Like any skill set, you need the basics and practice to stay safe.

What drives me nuts, I can drive a boat around at 20 knots in the dark and yet on the road on a rainy night, my tips and tricks that work so well on the water don't work on streets as well.

Then again, I drive boats more miles a year than I drive cars.

I just had cataract surgery last November. I was very nearsighted but still legal to drive with glasses. I had lots of trouble with glare and that was the qualifier for the insurance coverage. My vision is now 20/20 in one eye and 20/25 in the other eye. I no longer need glasses except for reading. Quite an experience since I wore glasses for 54 years.

Definitely need more light now when modeling.



Had cataract surgery twenty years ago. Huge improvement, but driving on asphalt on rainy nights is still hairy

I`m told one in 5 cataract surgery patients gets a misty "growth" on the back of the implanted lens, mimicking cataract. Unfortunately I`m in the "one" group. Lasering it off takes 30 secs, costs $970. One done one to go. Assured it does not recur.

Greetings,
Mr. mp. (post #7) VERY nice work!

RT Firefly said:

Greetings,
Mr. mp. (post #7) VERY nice work!

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Now all required is a train set in the salon or saloon which ever.:lol:

Yahoo!

BruceK said:

How good is your vision, especially at night? It`s an important safety issue. Many of us are at an age where our vision can have significantly deteriorated. ...............................

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I go to a well respected eye doctor every eighteen months. Is night vision something that is normally tested for? How about cataracts? I know she is very through.

I too have trouble at night. I see a halo around bright lights and sometimes have trouble seeing the lines on the street, especially when turning left into another street.

As for boating, I rarely run my boat at night but the few times I have, I haven't notice the same issues. Perhaps it's because most boats don't have headlights and there aren't typically streetlights to contend with.

When boating at night or early morning before dawn, I make it a point not to go so fast that I can't stop within the distance I can see.

WesK said:

I go to a well respected eye doctor every eighteen months. Is night vision something that is normally tested for? How about cataracts? I know she is very through.

I too have trouble at night. I see a halo around bright lights and sometimes have trouble seeing the lines on the street, especially when turning left into another street......

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I hoped a professional would come in on this, you`ll have to make do with my anecdotal experience and observations.
Cataract formation is routinely checked by opticians and ophthalmic examiners, I think it is easy to diagnose for a professional. Typical signs are poor vision in low light, little improvement from changing lens prescription,less need for sunglasses in bright light, loss of color intensity,and just plain lousy vision. Doubtless there are others. Maybe sun exposure is a contributing cause, especially reflected sun off water, boaters get lots of that.
The point is, you may not realize what you are missing, due to deterioration being so gradual, or how dangerous your loss of vision is. I had no idea how bad my vision had become, and no idea how much better it could be. The unrecoverable cost was substantial, even with Medicare for Dr. fees(ophthalmic guys here charge way over the Govt idea of fees), but my private hospital cover worked very well. Obviously cover varies, different places different schemes.
The procedure is not a problem, I was in and out in 3 hours each time, the eye cover comes off the same day. The procedure is done under a form of anesthesia. It is not normal to do both eyes at the same time, due to the risk of sympathetic opthalmia.The implanted lens is set for distance or reading, it can`t be both, you`ll need glasses for the one you didn`t choose, I chose distance vision achieving better than 6/6, so I use reading glasses.

WesK said:

I too have trouble at night. I see a halo around bright lights and sometimes have trouble seeing the lines on the street, especially when turning left into another street.
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Wifey B: You need to get that checked out. Likely cataracts but could be other things. Just not normal and need to find out what it is.

Amazing what they do now with cataract surgery. I've known many to have it and see better than they had in decades. Hubby's worn glasses since he was 5 so high risk for many eye things. So far, I've not needed them but I know I'm approaching that magic age.

There are eye drops that dissolve cataracts in development. They exist now for animals and appear to completely remove the cataracts w/o damage.
On the water, I travel slower at night.

God point to bring up, Bruce. As you said - vision loss is one of those gradual things that sneak up on you. You don't notice how bad it is/was until the problem id fixed.

My night vision is definitely getting worse. Mainly affecting close up vision, but recently the distance vision is also starting to worsen. I'll be quizzing my optometrist a bit more thoroughly this time.

I am late to this party, but I will chime in. After all, it is the only subject where I actually know anything.

Vision at night is an important issue. Lots of very good points have been raised.

First, I would just like to make clear that we are really talking about two sides of the coin, eyesight and vision. They are related, but not the same thing. You can have vision without eyesight, and can have eyesight without vision. Working definition is that vision is the process where we use our eyes to get meaningful information about our environment.

PSneed made that point really well. Training and practice can improve your ability to gain meaningful information about your environment at night. However, training and experience can only make up for decreasing eyesight so much.

Most of us are on the older side of 60 which means that most of us have cataracts. As was mentioned, cataracts usually progress slowly so that in most cases a person doesn't realize the change until has gotten quite bad. BTW, everyone will develop cataracts, all you have to do is live long enough. Cataracts are normal consequence of the lens of the eye continuing to grow. It is the same process that causes us to have issues with focusing in our 40s.

Cataracts can not only make the eyesight blurred, but they increase the effects of glare, particularly at night. They also can distort our color perception. Since these changes occur gradually it is easy for my patients to deny that they have any visual issues. Often I have to convince them over the course of a few years that they should have cataract surgery. Usually they resist getting the first eye done, but can then hardly wait to get the second done.

Cataracts are caused by changes in the lens of the eye. Well, there are other changes that take place as well. The first I mentioned already, the inability to focus at near. The other thing that happens is that our refractive error changes as well. This can also sneak up on folks. Someone who has legitimately had great eyesight most of their life may not notice that it is changing. It is easy to fool ourselves. Even a small uncorrected refractive error can significantly reduce our ability to see as well as we should at night.

"Night vision" isn't a thing. It is simply a way that we describe how well we function under low light conditions. It isn't something that your Doctor can measure. Your best bet is to make sure that you have yearly eye exams to ensure that you are seeing as well as you are able. The other reason of course is to identify the myriad of other problems that can cause significant vision loss or blindness but will not cause any early blurred vision such as glaucoma or retinal tears.

FWIW, the idea of eye drops to treat cataracts is not a new one. As was mentioned, studies in mice have been done but it will be decades at the earliest before we might see anything clinically useful.

FWIW, the one thing that will do the most harm to your night vision is smoking. Smoking double your risk of macular degeneration. If you smoke, stop. The other thing is that it inhibits your ability to see well under low light conditions. Again, if you smoke, stop.

Then there are the practical issues about night vision that most of you know well. Avoid bright lights at the helm. Turn your display's brightness way down. Remember that under low light conditions you lose your color vision, so those red unlit channel markers will appear black, so know your shapes.

Oh, almost forgot. Someone else mentioned posterior capsule opacification after cataract surgery. PCO, often referred to as an "after cataract" happens about 25-30% of the time. The capsule that holds the implant in place gets cloudy and can cause the vision to be blurred again. Correcting that is just a matter of a quick in-office laser procedure.

Anything I missed, let me know.

Dave, Thanks for your professional input.


I don't know offhand what sort of eye doctor mine is but she is not just one that gives exams in the mall eyeglass store.


I'm going to ask her a lot of questions the next time I see her. If I have to pay for something, I will. Eyesight is pretty important to my quality of life.

WesK said:

Dave, Thanks for your professional input.


I don't know offhand what sort of eye doctor mine is but she is not just one that gives exams in the mall eyeglass store.


I'm going to ask her a lot of questions the next time I see her. If I have to pay for something, I will. Eyesight is pretty important to my quality of life.

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Is your doctor doing a retinal scan? Are they expert in diagnosing and treating glaucoma?

You have a clear indication of a problem of some sort and since this hasn't been discussed adequately between you and your doctor, I have concern. I also question 18 months between exams at your age. A lot can happen in that time and annually is more in line with what most would recommend. How much as your prescription changed recently?

I wouldn't just leave it until "next time I see her." I would see either her or someone else now. I'd also know the credentials of any doctor I see. You're experiencing issues that generally call for an ophthalmologist although there are optometrists who do more thorough testing than some ophthalmologists but treatment will require an ophthalmologist. Also, read reviews online. They are sometimes quite informative when it comes to eye doctors.

At night peripheral vision is better to locate unlighted marks than looking straight ahead.

OK, she is an ophthalmologist. She does cataract surgery, Lasik, etc. I trust that she is good but I will ask specific questions.


My prescription hasn't changed in several years.


We will be seeing her again in just a few months and I haven't noticed any change that would require seeing her sooner. The insurance pays for every 18 months.


Bluestein Custom Vision - Charleston SC LASIK Laser Eye Surgery

bayview said:

At night peripheral vision is better to locate unlighted marks than looking straight ahead.

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Perhaps, but I find myself actually looking directly from side to side, both day and night. I don't run much at night. I'm more likely to be running just before dawn (getting an early start) than after sundown.

WesK said:

We will be seeing her again in just a few months and I haven't noticed any change that would require seeing her sooner. The insurance pays for every 18 months.

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This is the comment you made earlier, "I too have trouble at night. I see a halo around bright lights and sometimes have trouble seeing the lines on the street, especially when turning left into another street."

That's a symptom that you need an answer to. Dhays pointed out how common it is to not realize the changes since they're gradual. I imagine insurance pays for well visit every 18 months but probably more for interim visits to address health issues.

Her reviews are mostly good although a couple very negative. I have one concern in looking at her website. Lasik, lasik, lasik. Yet, not one mention of her typical eye exams and wellness exams nor of the equipment used during the course of those exams. I have seen some highly respected ophthalmologists whose practices became so Lasik oriented that their thoroughness and emphasis on routine eye care was greatly de-emphasized. I'm simply concerned as you report a problem and you haven't been given an explanation as to the cause. Halos are a symptom of cataracts, glaucoma and other conditions. Did you report these to the doctor?

I hope Dhays jumps back in on this.

I have slight astigmatisms in both eyes...

Has been that way since flight school in 1978.

I have slight halos and a few other slight issues but except for a couple years behind a desk near USCG retirement, all eye exams have me still 20/20 and I can still run at night, but certainly not like when I was still in my 20s.

WesK said:

Dave, Thanks for your professional input.


I don't know offhand what sort of eye doctor mine is but she is not just one that gives exams in the mall eyeglass store.


I'm going to ask her a lot of questions the next time I see her. If I have to pay for something, I will. Eyesight is pretty important to my quality of life.

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I am sure that she is checking for cataracts. Keep in mind that everyone over 60 has cataracts. I normally will tell the patient, but some Docs don't bother since they don't want to worry the patients unnecessarily. Remember that it is always important to tell the Doc what symptoms you are having. If you are experiencing halos and glare, mention it. She then can discuss it with you.

Wish you were closer...I would give you my old eyes some business....

BandB said:

Is your doctor doing a retinal scan? Are they expert in diagnosing and treating glaucoma?

You have a clear indication of a problem of some sort and since this hasn't been discussed adequately between you and your doctor, I have concern. I also question 18 months between exams at your age. A lot can happen in that time and annually is more in line with what most would recommend. How much as your prescription changed recently?

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Yes annually is what I recommend for anyone over 40 and it has nothing to do with changing the prescription in the glasses.

A "retinal scan" can mean several things. In general they are unnecessary in the absence of pathology but vital to monitor and help diagnose certain conditions.

BandB said:

I wouldn't just leave it until "next time I see her." I would see either her or someone else now. I'd also know the credentials of any doctor I see. You're experiencing issues that generally call for an ophthalmologist although there are optometrists who do more thorough testing than some ophthalmologists but treatment will require an ophthalmologist. Also, read reviews online. They are sometimes quite informative when it comes to eye doctors.

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On this I am afraid you are wrong. Part of it will depend on what part of the country you are in, but for general eye care you are usually better with an optometrist and get referred to a sub-specialist as needed. Whom I refer to depends on the particular problem. Today so far I have made a referral to a cataract surgeon for cataract surgery, a retinal sub-specialist for a patient with progressing diabetic retinopathy, and am about to see a nutty patient whom I referred to a glaucoma specialist who simply wants my assurance that the surgery that was recommended is appropriate. The point is that the best eye surgeon (opthalmologist) for the patient depends on the problem.

In short, stick with a good optometrist until surgery is required or recommended and then follow the recommended referral. Patients who write reviews have no idea if the Doc is really good. All they know is if they like you or not. I do know who the good surgeons because I am the one who deals with the aftermath of the surgery, both good and bad. I have tons of glaucoma patients that I am treating on a daily basis. They do not need to see an opthalmologist for that.

dhays said:

Yes annually is what I recommend for anyone over 40 and it has nothing to do with changing the prescription in the glasses.

A "retinal scan" can mean several things. In general they are unnecessary in the absence of pathology but vital to monitor and help diagnose certain conditions.



On this I am afraid you are wrong. Part of it will depend on what part of the country you are in, but for general eye care you are usually better with an optometrist and get referred to a sub-specialist as needed. Whom I refer to depends on the particular problem. Today so far I have made a referral to a cataract surgeon for cataract surgery, a retinal sub-specialist for a patient with progressing diabetic retinopathy, and am about to see a nutty patient whom I referred to a glaucoma specialist who simply wants my assurance that the surgery that was recommended is appropriate. The point is that the best eye surgeon (opthalmologist) for the patient depends on the problem.

In short, stick with a good optometrist until surgery is required or recommended and then follow the recommended referral. Patients who write reviews have no idea if the Doc is really good. All they know is if they like you or not. I do know who the good surgeons because I am the one who deals with the aftermath of the surgery, both good and bad. I have tons of glaucoma patients that I am treating on a daily basis. They do not need to see an opthalmologist for that.

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I did not mean to imply that an ophthalmologist was the place to start. We go to an optometrist, for a couple of reasons. One, you note, is that they will refer you to the right specialist. The second is that we've found they are much better at prescriptions for lenses on the whole. Our optometrist is also well trained to assist glaucoma patients. I didn't mean it to in any way be anti-optometrist as by my own choice I'm clearly pro-optometrist. I switched when young and going to my father's ophthalmologist and cataract surgeon who couldn't get me a good prescription which the optometrist I went to the first time got it perfect.

I did mean ultimate treatment if such as a cataract would require an ophthalmologist, nothing more. In fact, you will find I did post another reason for an optometrist as opposed perhaps to the ophthalmologist Wes is seeing. That is an ophthalmologist focused too much on certain aspects of practice, like lasix.

As to reviews, I find some to be very helpful. When multiple patients talk about having issues not addressed until they went elsewhere or talk about lack of communication, that's an indication. Repeated, you barely see the doctor, he just darts in and out. Also, things like the waiting time are helpful to be aware of.

As to surgeons, sometimes reviews just prepare you for a personality. Those who had problems with the surgery are difficult to give weight too because clearly you don't know the percentage, but you do seem some surgeons with far more complaints than others. Still, I agree with you on having a doctor you have confidence in refer you. I think of the optometrist as the general practitioner for your eyes.

The other thing you recommended which was annual eye exams for anyone over 40. I hope everyone takes note of that. Just because your vision is good, doesn't mean you don't need your eyes checked. Call it a wellness exam.

WesK said:

OK, she is an ophthalmologist. She does cataract surgery, Lasik, etc. I trust that she is good but I will ask specific questions.


My prescription hasn't changed in several years.


We will be seeing her again in just a few months and I haven't noticed any change that would require seeing her sooner. The insurance pays for every 18 months.


Bluestein Custom Vision - Charleston SC LASIK Laser Eye Surgery

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She looks just fine. Her website is off-putting to me as it is full of hype and a bit short on specifics, but that is not too unusual in this day and age. She most certainly will be able to address your concerns about the halos and glare.