new boy intro & night driving

[paulmorris]

hi - great to find this website, glad to know i'm not the only one suffering from this awful condition

my name is paul, i'm 37 and i've been suffering from dry eyes for about seven years. i was diagnosed with dry eyes when i started suffering from acute eye pain while working as a proof-reader. since then, although i've struggled to stay in my chosen field of publishing, i've had to change career and now work as a mental health worker, a job which means the majority out and about in the community, and most importantly not in front a computer!

re treatments, i've had a few plugs inserted into my upper and lower tear ducts, which tend to work for a while only. my opthamologist reckons that my tear duct probably expands around the plug once it's inserted. at the moment my left eye is fine, but not my right eye - i'm holding out that this new product that expands in the tear duct may be the answer. i'm also practising lidcare daily, although am only cleaning my eyes with cotton pads soaked in hot water, as i found solutions such as baking power and saline solution were causing me discomfort

one thing i'd like to know is what products are there to help with night-driving? my condition's bearable during the spring and summer, but it's in the depth of winter that i really feel it kick in, with the increase in artificial light and the onset of car headlights when driving.

i currently use some night-driving shades and a glare visor, both bought from halfords (uk car store), but naturally this also cuts down my night-vision. as a consequence i avoid night-driving when at all possible other than what is strictly necessary (ie, to get back from work) - therefore i was wondering how other sufferers cope with night-driving, and whether anyone could recommend any products that would limit the glare and brightness of car headlamps without limiting night vision, or maybe i'm just entering the realms of fantasy here?

many thanks,

paul morris

[Kyle]

Hi Paul,
I am so sorry you are going through this. If you haven't yet, please take the time to read through the threads already on this site. You will find SO much valuable information!
I am almost a year out from lasik surgery and I have terrible night vision. I barely drive at all at night except when I absolutely have to. It really sucks because I am fairly young and single, so it definitely cuts into my getting out.
One of my docs prescribed Alphagan to help me see at night. I decided not to get the prescription filled though after talking to several people who said that although it would help me see better at night it would make my dry eye symptoms worse. I couldn't bear the thought of that happening so instead I just suck it up and I don't drive at night.
You might want to check into that medicine and ask around for anymore.
Good luck and hang in there!

[kaypeeoh]

Hi Paul,

My problems driving at night were caused by LASIK. I haven't been able to drive after sunset for seven years now. I tried Alphagan and found my eyes reacted badly to the stuff. I then tried dilute pilocarpine. Pilocarpine is an older drug used to treat glaucoma. It acts by constricting the pupil, same as Alphagan. It comes as 1 or 2 percent strength. I found by diluting it to 1/8th percent it worked without causing headaches. The only downside to constricted pupils is it makes the dark darker. Things that might be difficult to see in poor light become impossible to see.

What worked better for me was RGP contact lenses. These rigid lenses reduce starbursts by about 80%, enough to allow driving at night. Unfortunately I haven't found lenses that I could tolerate for more than a couple hours a day.

I don't know if either suggestion would work for you. By constricting my pupils, the eyes act like pinhole cameras. Everything is sharp. Because the eye is looking though a small opening, a lot of the scarring caused by LASIK is hidden by the iris.

[Kyle]

That's a good point. I wanted to mention that I tried the contacts too and I was amazed at how much they helped my night vision. Unfortunately when I took the lenses out I could tell that my overall vision was decreasing. It scared me so much I just decided to forget about driving at night and just concentrate on getting better during the day. Thankfully my vision returned to what it was right after the surgery.

[kaypeeoh]

Kyle, it sounds a bit like 'spectacle blur'. The hard lenses alter the shape of your corneas but it's temporary. My earliest lenses did that. The later lenses fit better and didn't cause spectacle blur.

[paulmorris]

thank you both for your suggestions - sounded like the contacts might be worth a shot, i must research to see whether they make glasses as well. do the contacts reduce brightness as well as glare? pilocarpine sounds ideal, but i think the risk of hitting a pedestrian/cyclist wearing dark clothes crossing the road might be quite high if it makes dark things darker

[DrG]

LASIK or not?

Paul, I did not see where you stated that you had LASIK or some other type of refractive surgery. I believe that the previous responders who recommended contact lenses for night driving all had LASIK, in which case contact lenses would be of some benefit to correct a small optical zone. It apears as though you have primary dry eye.

I'm not sure that I would recommend contact lenses for you, except perhaps those large ones that Lucy is using, called scleral lenses. They are great "moisture seals" which may also have some benefits for your night vision.

DrG

[paulmorris]

hi dr g - yes, you're quite right, i'm not a LASIK casualty - i have tried special contacts for dry eye in the past, but found they just dried my eyes out too much - i'll check with my optometrist to see if they were scleral lenses

[Rebecca Petris]

If they were sclerals you would definitely know it (sclerals are highly specialized, very very large gas permeable lenses - really more of a prosthetic device than a contact lens).

Is it certain that your night vision symptoms are directly related to dry eye, i.e. did both problems start around the same time?

[jcorbett]

If dryness is causing the glare, perhaps some clear goggles? These keep moisture in your eyes and may cut the glare. I notice when my eyes are drier, the glare is worse.
If you close your eyes and rest them a bit and do a warm compress and lubricate your eyes well before going out and driving at night, does that help? Does putting drops in while driving cut the glare, even though temporarily?
I don't know where you live, but if the heater is on in the car now, that will dry your eyes out considerably. You might benefit from goggles in that case.

[Delilah]

Welcome Paul

Paul welcome to the site, I read your post and I have a horrible time with night driving myself. I was diagnosed with MGD and LD, I have extreme sensitivity to light, there isn't a day that I don't leave without my shades. I suggest getting your car windows tinted as dark as you can and have that dark strip of tint on the top of your windshield, it will make it a lot easier to drive at night I am sorry your going through so much pain, I am not sure what sort of drops are for pain other than steriod drops which I highly disagree with. There is one new drop that is non-steroid for eye pain, its given to people that have had cataract surgery and my dumb eye doctor gave it to me lol, its called Nevanac. Its suppose to help with eye pain and its a non-steroid drop. I don't know why my eye doc gave me that and frankly he couldn't help me with what I suffer from, I think he was just giving me eye drops to give away But I did try it and found it quite soothing to the eye. God bless and again welcome. Ciao Delilah

[paulmorris]

hi chaps, many thanks for your replies, i wish i'd joined this service years ago! to answer in order:

hi rebecca - a good question - i can't remember my night vision being as bad when i was first diagnosed, i think my problem was exacerbated by forcing myself to work at computer screens for long periods of time rather than change career, as i've now done

hi jcorbett - many thanks, i'll give the goggles and compress a try - i've tended to find in the past that they just get amazingly steamed up, tho - what brand/goggle treatment would you recommend? i see that the dry eye shop's got some for sale.

i always put drops in before i drive, but that doesn't seem to help that much after a while, although things are ok for that initial 5ish minutes. certainly in the past when my plugs have worked and my eyes are fully hydrated, then light sensitivity has been alot less, so maybe goggles would be the way to go. also, i'd fully agree with you about a heater.

hi delilah - many thanks for your welcome - can i ask what MGD and LD are? getting car windows tinted is a great idea, although i'm afraid of cutting down my night vision too much, but i s'pose if it's legal it can't be that bad. i've already got a strip across the top of the windscreen, which i find really helps for day driving - actually, i don't find just one dark enough, so i'm in the process of putting a few on! what i might do as well is part some of that tinted strip on my wing mirrors - at the moment glare/brightness from car headlights behind me is really bad

re anaethestic drops, thanks for the suggestion, but my reasoning is that the eye's registering pain for a reason and that ******g the pain is only going to make it worse when the painkiller wears off - i know alcohol's another good (widely available) anaesthetic, but maybe not when i'm driving!

anyway, thanks once again for all your tips, muchly appreciated (these smiley faces are great, aren't they?!?)

paul

[jcorbett]

I use the wiley-x glasses and they don't fog up on me. Cost was around $75. I have interchangeable lenses so I can go from sunglasses to regular glasses. Panoptyx are real popular around here, too. Rebecca has a post out there somewhere where she compares the different brands. You may want to take a look at it and make your own decision.
You can find these glasses at local dealers and go try them on. Some people have to search a bit to find a good fit.

[Rebecca Petris]

Rebecca has a post out there somewhere where she compares the different brands.

Here is the thread.

I wore the Wileys for driving for about a month and a half. I'm back in Panoptx now (Sirocco). I liked the Wileys a lot - better field of vision - but it's actually just starting to get chilly enough here that I'm turning the heat on during morning commute and need the better protection of the Panoptx. Also, part of the earpiece from the Wiley came off and I haven't got around to fixing it yet.

I occasionally got a teeny bit of fogging with the Wileys, just a spot in the center but if I just move them down my nose a bit for about 10 seconds it clears.

MGD = Meibomian Gland Dysfunction, i.e. problems with the lipid-producing glands which results in higher than normal evaporative loss of tears. I think this condition is grossly under-diagnosed - many people don't know they have it even after visiting several doctors.

[paulmorris]

many thanks chaps, i'll see if these brands are available in the uk