Fading night vision in the senior population is a problem frequently associated with cataracts which interfere with the normal refraction of light. But while removal of cataracts can improve night vision, it can also create an unpleasant side effect called dysphotopsia that leaves an individual, once again, struggling to see as darkness approaches. Dysphotopsia is a treatable problem which includes a number of optical distortions which can negatively impact night vision. Visual acuity difficulties due to headlamp glare, halos, and arcs are frequently the result of dysphotopsia. This condition can occur after a successful cataract surgery involving intraocular lens replacement or, in rare cases, as an anomalous manifestation of a neurological disorder.
Individuals who suffer with night blindness cannot safely drive at night. They may experience difficulty with depth perception in dimly lit areas and have trouble adjusting to abrupt lighting changes that leave them floundering in the darkness. In areas of low light, dysphotopsia can cause visual distortions often described as similar to looking at the world through a watery lens.
Treatment for any perceptible changes in night vision, including those associated with dysphotopsia, should always begin with a medical evaluation by a specialist trained in the diagnosis and management of eye diseases. An ophthalmologist can usually determine the cause of night vision difficulties and work with a patient to develop a treatment protocol for addressing symptoms of dysphotopsia.
Night blindness can be associated with a post-operative condition after cataract surgery and a subsequent lens replacement. Negative dysphotopsia manifests as a temporary shadow that comes and goes intermittently on the temporal side the implanted lens. In most cases, these shadows resolve on their own as the brain adjusts to the placement of the new lens. Patients who cannot tolerate prolonged symptoms of negative dysphotopsia are sometimes treated with a second lens replacement. Other symptoms of post-surgical dysphotopsia can be treated with nighttime driving glasses to minimize flaring. Over-the-counter solutions used to treat dry eyes can also help to minimize flashes, glares, and arcs experienced as the result of positive dysphotopsia by constricting the pupils. These visual anomalies are believed to be due to reflective light bouncing off the outer edges of the lens. Over time, as the brain learns to compensate and patients become less hyper-vigilant, these symptoms also tend to disappear.
Studies suggest that eating foods that are rich in Vitamin A and natural sources of zinc may help to offset loss of nighttime vision. Blueberries, which are high in antioxidants, are believed by some to improve the ability to see in the dark. While dysphotopsia is frequently a transient problem that is eventually resolved, loss of night vision can be due to more than just this condition and secondary causes can be masked by symptoms associated with cataract surgical recovery. For this reason, natural and homeopathic remedies can be supportive treatment strategies in managing loss of night vision.
Improvements in lens replacements have decreased the numbers of individuals who experience night vision difficulties as the result of post surgical dysphotopsia. Treatments for symptoms that appear similar to dysphotopsia but may be organic in nature generally necessitate interventions to care for underlying pathologies. Because it can be difficult to determine a definitive cause for dysphotopsia, it is important for patients facing cataract surgery and/or lens replacement to be prepared to cope with short-term optical distortions. They should also be willing to allow an eye specialist to rule out any potential underlying pathology that might be contributing to loss of visual acuity and night vision.
For many, cataract surgery results in significant vision improvement with no complications. But for the occasional individual who suffers with dysphotopsia in the aftermath of lens replacement, patience is essential to allow for adjustments and resolution of vision within the first few weeks after surgery. Those who are unable to tolerate residual symptoms that include problems with night vision should visit with their ophthalmologist about follow-up surgery to correct this problem.