mcrh.org
*Home>>>Low Vision

Looking for serious explanations/similar people that feel drugged or tunnel vision while driving at night?


I drive for a living, and have to drive at night. For a long time now, I have dealt with feeling drugged while driving at night. It's hard to explain. I don't feel woosy or dizzy, it feels like it's in my eyes. But I can see clearly, though I have to really concentrate to comprehend signs. It just feels like I've been drugged. My reactions are fine, but I become very paranoid, and find that I'm 2nd guessing myself. I am a healthy 28 yr old female, have had bouts with hypoglycemia, but not recently. Mom thinks I may not have low blood sugar, but instead diabetes. Any ideas at all? I am locked into this job, and avoid driving at night when possible, but sometimes it has to be done. Thanks!

On the back inner surface of each eye is a unique tissue called the "retina." All images entering the eye fall on the retina - just as images entering a camera fall on the film. The human retina contains two types of light-sensing cells:

The "cones" are specialized cells which fill the central part of the retina. The cones sense and discriminate colors. They also see most clearly, giving us our sharp, clear, fully colored, daytime vision. The cones, however, see only ahead but not to the sides (no peripheral vision), and they do not sense very dim light. The cones function with and complement the functions of other retinal cells called the "rods."
The "rods" are specialized cells which fill the peripheral or the off-center portions of the retina. The rods see only in black, white and gray. They do not discriminate colors. The rods give us side or peripheral vision, in bright daylight, in very dim light, and in mixed lighting conditions such as being on a dark road at night with bright oncoming headlights shining into one鈥檚 eyes. In very dim light, with no bright lights visible, a person is probably seeing with his rods, only. This is confirmed if everything appears in black, white and gray 鈥?without colors. In a dim-light environment, with one or two bright pinpoint lights, the person sees with both the cones (for the bright light) and the rods (for the dim light). Unfortunately, prolonged viewing of a bright light in a dim field causes the wide pupils to close to smaller sizes and may also desensitize the rods - temporarily reducing the person's ability to see in dim light. Thus, nighttime drivers want oncoming cars to lower their headlight beams, to prevent their being blinded. Once the bright light is gone, the pupils open up again and the rod cells resensitize, thus restoring good night vision. Most aircraft and some autos use red lights to illuminate the panel instruments because this color does not contract the pupils or overload the rods.
Category 1 鈥?Blurred Vision in Dim Light 鈥?with sharp vision in moderate to bright light. These people see clearly in daylight but with blurred vision at night or in semi-darkness. They usually do not complain of "too little" ambient light and they do not complain of glare. People with this problem are the most numerous of all the people with night vision impairments and are often in their 40's or 50's. MOST CAN BE HELPED EFFECTIVELY with a pair of prescription glasses prescribed especially for night driving or outdoors night vision at distance.

MOSTLY AFFECTED are people whose ages range from the mid-40's to the mid-50's who are starting to become presbyopic due to aging. Typically, the person has some slight refractive error that does not affect visual acuity in bright light 鈥?but does reduce the person鈥檚 visual acuity in dim light. This results in the 鈥渂lurred night vision鈥?complaints. In most cases, both eyes are affected equally. People whose two eyes react differently should refer to additional information below.

THE CAUSE of "impaired night vision" in these cases is, most often, variation in the "depth-of-focus" of each eye with exposure to bright or dim light - and the resulting closing or opening of the eye's iris. In bright light, with the iris closed and the pupil of the eye small or even 鈥減inpoint,鈥?there is great depth-of-focus so that objects near and far remain in sharp focus. This conceals minor refractive errors such as common myopia (nearsightedness) and/or astigmatism (non-uniform corneal curvature distortions). A person attempts to drive at night in an area that has little or no ambient artificial lighting. The pupils become large as the iris opens. More light comes into each eye so that there is no complaint of being "night blind." However, with the large pupils, the depth-of-focus is reduced and the distant scene or road, sidewalk or other vehicles becomes slightly out-of-focus and blurred. This results in the complaint being: "impaired night vision." For some people, blurred night vision results from a problem with just one eye. For other people, both eyes must be similarly affected for the combined vision with both eyes to appear blurred. Therefore, both eyes must be examined and refracted using trial lenses.

THE REMEDIES for this condition are usually simple and effective. One hundred percent correction is possible for most people who are affected. It is interesting that many with this condition do not wear any corrective lenses because, in bright light, they enjoy sharp vision. It is only with aging that the night vision started to become blurry. Some people do wear corrective lenses and still have this problem. Usually, the glasses were prescribed a long time earlier and slowly became outdated 鈥?or else the person was refracted (and prescribed) in bright light rather than in dim light.

People with impaired night vision, as described in this section, should go to an ophthalmologist for complete examinations of both eyes. First, this will rule out various eye conditions or diseases. Then, it will give the eye doctor an opportunity to evaluate the patient鈥檚 visual acuity at distance, in very dim light, using trial lenses. It is recommended that dim-light testing be done using trial lenses two times. The first time, the eyes should NOT be dilated with eye drops. This will enable the doctor to ascertain that both pupils widen quickly and fully in the dim light, by themselves (without eye drops). Afterward, the pupils can be dilated with eye drops for "worst case" testing for reduced acuity or blurred night vision.

Once it is determined that this is the problem, namely that there is sharp vision with pinpoint pupils and blurred vision with open or enlarged pupils (due to reduction in depth-of-focus caused by the larger pupils), corrective lenses can be tried. So long as the trial lenses are used in dim light that emulates night driving conditions, with the pupils widened, lens prescriptions should be readily determined for effective "night driving glasses." Happily, the lenses worn for the sharpest possible night vision will also work as well for day vision (when the pupils are pinpoint sizes). The reverse is not true. Lenses prescribed based on bright-light testing will work well for day vision 鈥?but not necessarily for night vision.

Category 2 - Blinding Glare and/or Halos Around Lights - disrupting useful night vision or blinding the driver鈥?but with sharp vision in dim light when there are no lights to cause glare. These conditions can cause deadly auto accidents. People with this problem are very numerous and often are not otherwise handicapped. Typically, glare problems of this type are caused by lesions in one or both eyes.

In some cases, there may be a developing cataract in one or both eyes; in other cases, the cause can be the result of a scratch, lesion or other defect in the cornea of either or both eyes. Some people who undergo LASIK treatments develop these problems. Usually, these problems can be corrected, controlled or improved by appropriate medical or surgical treatments.

Note: People with normal fused, binocular vision may be unable to drive safely or comfortably at night when only one eye is damaged. This occurs because the brain fuses the images from the two eyes into a single composite image. Even if the excessive glare comes from just one eye, it can impair the composite image from both eyes, thereby resulting in accidents.

Most people with this type problem can be helped medically or surgically by a qualified ophthalmologist (medical eye physician). Exceptions: Many patients with damaged corneas can be helped with corneal surgery or a corneal transplant. Some cannot, especially those having corneal scars from active, chronic viral infections that cannot be cured. The problem is that some of these patients would still have the viral infection after a corneal transplant so that the new cornea would quickly become damaged, just like the old cornea. For these "incurable" patients there still is hope because of special lenses or other devices that can provide functional help.

In some cases that affect one untreatable eye (when there is a good second eye that does not have glare or halo problems), special glasses or other devices may be helpful. These are some possible methods for helping:

Remedy A - people with only a mild problem can sometimes wear special driving glasses while retaining the night driving use of both eyes. The lenses, clear or prescription (for giving sharpest night vision) can be "gradient tinted" so that glare can be immediately filtered out by merely moving the head and eyes slightly. CAUTION: Never wear sunglasses while driving in dim light! The gradient tint lets the driver selectively, and momentarily filter out the glare and does not compel him to lose night vision entirely as would uniform tint sunglasses. Either of two methods can be used for making these glasses: (1) gradient tint both lenses from top to bottom. Typical: 90% at top, graduating to 5% two thirds down. Or 鈥?(2) gradient tint both lenses from left side toward right side. Typical: 90% at left side of each lens, graduating to 0% one third toward the right, from the left edge of each lens.

CAUTION: Be sure to GET DRIVER TRAINING On-The-Road, under night driving conditions, from a qualified driving instructor before driving alone at night.

Remedies For People with More Severe Glare or Halo Problem:

Remedy B 鈥?It is possible to wear a patch on the impaired eye when driving in lighting conditions where glare and/or halo problems occur. Advantages: the glare and/or halo problems are eliminated. Disadvantages: the driver has no peripheral or side vision on the side of the patched eye; he has monocular vision 鈥?not binocular stereoscopic vision 鈥?and may have difficulties judging distances and speeds (until after much practice). Or 鈥?

Remedy C - Wear eyeglasses, Rx or clear, with a circle of black tape on the inside of the lens of the impaired eye. Advantages: the glare and/or halo problems are eliminated because there is no forward vision through the tape; peripheral vision to the side, has been preserved. Disadvantages: the driver has only monocular vision ahead 鈥?not binocular stereoscopic vision 鈥?and may have difficulties judging distances and speeds (until after lots of practice). Remedy C is preferred over Remedy B
Category 3 - Insufficient Perception of Dim-Light may lead to accidents. There may be different causes for different people. Possible causes and possible solutions are discussed below. This condition, often referred to as: "Night Blindness" may be caused by something as simple as a vitamin deficiency, or by a controllable disease process such as glaucoma, or by a less controllable, progressive disease such as retinitis pigmentosa (which damages or kills the retina's rod cells). Even when less correctible (as with retinitis pigmentosa), there are some special optical devices available that can be functionally helpful.

It is important for people with this problem to first have a thorough examination by an ophthalmologist. This should include visual acuity in both brightly lighted 鈥?and dimlight conditions. It should include examinations of the eye's cornea, lens, vitreous and retina. And it should include testing internal eye pressure and then plotting the patient鈥檚 visual fields. The pupillary responses to changing light levels should also be tested.

These exams will identify or rule out: (1) glaucoma (which is 100% treatable) and (2) retinitis pigmentosa (progression of which can be slowed but not stopped). If either of these diseases is diagnosed, then treatment must be started immediately to arrest or slow the disease. These two eye diseases typically result in BOTH night blindness AND reduced peripheral vision which worsens progressively over time unless treated.

NOTE: If both these diseases are ruled out, visual fields and pupillary responses are normal, and there is no apparent cause for the night blindness, then the patient may be lucky enough to have a correctible condition caused by vitamin or nutritional deficiency. An ophthalmologist who is a retinal specialist should be consulted to determine if the night blindness can be overcome with vitamins, nutritional therapy, or medications.

Driving with either glaucoma or retinitis pigmentosa may or may not be feasible depending on the person's overall vision. If the daytime corrected visual acuity is less than minimum state requirements, the person cannot drive at all. If the daytime acuity is adequate, then the other two issues must be addressed: (a) visual field and (b) night vision (dim-light sensitivity).

VISUAL FIELD minimums are specified by some states but not by others. If your state has minimum specifications, then your eye doctor will know if you can or cannot be licensed to drive. If you meet the state requirements 鈥?or if there are none in your state 鈥?then driving is a matter of the driver鈥檚 choice. Some hints:

Hint 1 - If overall horizontal visual field is less than 110 degrees, then do NOT drive.

Hint 2 鈥?Assuming 20/30 or better corrected visual acuity and a horizontal visual field of 110 degrees or more: (a) have 180-degree wide angle inside rearview mirror installed in car; (b) be sure the car's outside mirrors are adjustable from inside the car; and (c) take a qualified driving instructor to train you, on the road, in constant head & eye movement scanning techniques 鈥?and in defensive driving techniques 鈥?appropriate for your unique situation. Daytime driving, only!

NOTE: Field-Expander WALKING GLASSES may be available for people with untreatable "Tunnel Vision" for functions other than driving. Please see information below about "Field-Expander Eyeglasses for People with Tunnel Vision."

An uncorrectable NIGHT BLINDNESS problem mandates that the person NOT drive at night or at dusk. There is nothing that can be done about this, for night driving.

To facilitate safer walking in dim light for a Night Blind person, indoors or outdoors, either of these two assistive devices can be used: (A) an inexpensive fluorescent-tube floodlight that is battery operated and worn on a strap around the neck. Used, hands-free, this device enables a night blind person to more safely and easily walk around, indoors or outdoors, because it illuminates the way. A person might not be welcomed while using a visible light of this type, in a theater or restaurant because the light might disturb other people. Or 鈥?(B) a hand-held night vision scope (somewhat costly) which is held to the eyes like a monocular or a binocular telescope. An electronic screen displays brightly enough to be seen with daytime vision, the dim nighttime scene it is viewing. These devices were designed for military use but are available commercially. They do not use visible light and so do not disturb others.

Visual Field Expander Glasses for People with "Tunnel Vision" can also be helpful to people with more severe peripheral vision losses. A normal field of vision is in the range from 130 to 150 degrees wide. Generally, a person with progressive peripheral vision loss begins to feel handicapped when his field decreases to 110 degrees or less. When walking, he has to keep turning his head and eyes back and forth to know who or what is on each side. By the time the field width has decreased to 70 degrees, the person is well aware of his handicap. Once it decreases below 50 degrees, it becomes increasingly difficult to walk safely. It is in this range, or slightly lower, that the person is apt to begin using a cane or walking stick for increased safety. The visual fields can continue decreasing until they are as narrow as 5 degrees. Again, effective treatment can completely stop the progressive field loss in people with glaucoma. Effective treatment may slow, but not stop, the progressive loss in patients with retinitis pigmentosa.

Some "Low-Vision" clinics can make "field-expanding" eyeglasses to help people with advanced tunnel vision, for functions other than driving. Examples: (A) for people with fields 75 degrees or wider, central vision remains essentially normal. What is lost is the side vision, to either side 鈥?and the ability to turn one鈥檚 head either way, to see to the rear. A vertical strip, base-out prism segment can be cemented to each eyeglass lens, toward the outside edge. This enables the person, with only a very small and quick movement of the eyes, to see to either side or around the side toward the rear. (B) for people with visual fields of 20 degrees or less, eyeglass lenses can be made in a special bifocal form. The top half of each lens is clear or the person鈥檚 distance Rx. In the lower half of each lens is a reverse telescope, or a door peephole viewer, which enables the person to see a large area view because it is reduced or minified to remain within the existing central visual field. The viewing angle and minification ratio can be varied to suit the visual field size, the visual acuity rating, and the functional needs of the patient.

Category 4 - Combinations of Two or More of the Above Conditions in the same person can result in the person becoming even more functionally handicapped. Sometimes, each problem can be separately helped 鈥fter all have been identified. In other cases, some but not all of the problems can be helped, leading to functional improvements but not necessarily complete restoration to normal functioning.

i was having the same problem...found out it was my CAR! The catalytic converter was clogged. Should have been 2"...was 2mm!! Report It

I seriously suggest you see a doctor, am not sure if you are describing sleep depravation or fatigue, but I do know you need to see a doctor. Hypoglycemia is low blood sugar, it has different symptoms and it could be severe but unlikely life threatening. Now, diabetes is very serious, depending how high your blood sugar gets you will have different signs and symptoms and it can lead to blindness and coma. Please see a doctor

賲賲賰賳 賳鬲毓乇賮 賲賳 賮囟賱賰 丕賳丕 亘爻 賲丨鬲丕噩 賱氐丿賷賯賴 賲禺賱氐賴 賲賲賰賳 鬲賰賵賳 丕賳鬲賷 丕賵賱鬲賷 丕賷賴 賲賲賰賳 丕賴 賴 賴 丕賳丕 丕爻賲賷 丕爻賱丕賲 賵丕賳鬲賷

I really don't think it's a medical condition, every once in a while that happens to me too... but I don't have any medical issues. I think it has something to do with your eyes adjusting to the dark maybe.
3 minutes = 33% of our max "night vision"
30=66%
3 hrs = 100%

remove sunglasses

Start with a physical to make sure you don't have a medical problem. If not, the "sameness" of the road at night can be almost hypnotic. I have done road trips with my kids and had the same experience. Talk to other drivers and I bet they will share the same problems.

yeah you might have a blood problem.or you just might need glasses.if you have not been yet go to a doctor.

I too have a hard time driving at night and I'm seeing eye doctors because my vision is less then good. You might be suffering from a condition called Night Blindness. I have it.

Google Night Blindness, Impaired Vision, corneal edema.

And most important: SEE A DOCTOR! Don't mess around with your vision.

Tags
  Lyme Disease   Lupus   Lung Transplantation   Lung Diseases   Lung Cancer   Lumpectomy   Low Vision   Low Blood Sugar   Lou Gehrig Disease   Long-Term Care   Living Wills   Liver Transplantation   Liver Spots
Related information
  • Question about contact lens powers?

    You might want to try the higher power for a little longer -- it might take your eyes a week to adjust to them. If you've already tried them at least that long and definitely don't like ...

  • What are the different benefits of Sunglass lens' colors?

    Red-Orange tends to reduce glare and haze from the near ultraviolet part of the visual light spectrum. This tends to reduce glare on hazy days. Yellow has been used for years by sportsmen as a sh...

  • What type of glasses does an optometrist usually recommend for a post RK that uses a computer a lot?

    To minimise glare effects, you want a reasonably high level of ambient lighting, and the contrast/brilliance on the screen only just high enough to give clear resolution of the letters. (more is ...

  • Is my Lasik irritation normal?

    I went through the same exact thing. And the halos, and irritation did finally subside. I didn't have that much irritation but the halos--and the halos caused blurriness. I never thought it wo...

  • Whether Retenitis Pigmentosa can be cured?

    I am sorry to say that it doesn't appear that this can be cured (although I am not a doctor): Expectations (prognosis) The disorder will continue to progress, though at a very slow pac...

  • What glucose level is considered severe hypoglycemia?

    Are you in the US? If you are using the mg/dl measurements, your blood glucose is dangerously low. It sounds like a situation where hospitalization would be the best course of action. A 2 week w...

  • I have been on Effexor XR for about a week,Im having some side effects like my vision,eye pain,worse confusion

    Don't stop it. I am taking effexor and the first days, couple of weeks, I felt differnt. I had a bit of blurred vision, nausea, funny feelings when i stood up, like confuded and days seems h...

  • Is any drug usfull fo glaucoma to preserve field of vision?

    Visit your Optician. They may know of something or they may be able to transfer you to the eye hospital. Don't leave it too long, you only ever get one pair of eyes. Good luck x

    ...
  •  

    Categories--Copyright/IP Policy--Contact Webmaster