Vision and driving


Are you becoming more uncomfortable driving at night or avoiding it completely? Do you need a bright light to see anything?

“Seeing” is not just 20/20 on the eye chart. Just to list a few other factors, there is color vision, stereo vision, contrast sensitivity and your eyes ability to adapt to light and dark. Changes to your ability to see are very normal as we get older, not necessarily disease or cause for alarm. But the risk of developing eye disease such as glaucoma, macular degeneration, and cataracts, does increase with age. So, it is a good idea to have an annual eye exam to rule out overt disease.

That being said, these “normal” eye changes will affect your visual task performance, specifically driving.

Sometime in your 40s, the lenses in your eyes begin to thicken and become less elastic, creating difficulty with focusing, adjusting your vision for different distances. Normal: yes. Solution: distance and/or reading glasses or multifocals.

As the lens thickens even more (50 to 60 years old), it becomes less clear and your vision gets hazy (beginning cataracts) and you might experience more glare during the day and at night as headlights may be more bothersome. Normal: yes. Solution: anti-reflective coating, tints or in cases of severe haziness, cataract surgery might be appropriate

Contrast sensitivity, the ability to discriminate an object from its background (for example, seeing white rice on a white plate or seeing other cars or pedestrians at night) and dark adaptation (being able to see and adjust quickly when going into a dark place) both affect our vision in our 60s and 70s. Cataract development, a normal aging process, may be one of the main causes. But there is also evidence of retinal photoreceptor loss. It can sometimes take 10 minutes longer for elderly individuals to adjust to the dark. Normal: yes, though severe changes may be a sign macular degeneration. Solution: cataract surgery, yellow tints, eye vitamins.

Peripheral vision decreases a few degrees per decade beginning around 50. Normal: yes, but get checked regularly for glaucoma which affects peripheral vision, especially in the Japanese population. Normal: yes. Solution: Look both ways twice for pedestrians who are right in our blind spots before turning in or crossing an intersection, use all three mirrors and use your backup camera if you have one.

Impaired motion perception (seeing moving objects) and slower visual processing speed (seeing and understanding what you are seeing and then deciding what to do about it) both make driving more of a challenge and happens often in our 80s. However, these changes are not inevitable and are largely dependent on individual differences, general health and lifestyle. Normal: yes. Solution: healthy lifestyle, vitamins, cognitive training and speed practice.

Increased auto accident risk is a problem we are all faced with as our vision changes. Make sure you have the best possible vision correction, have regular eye exams and see your primary care physician annually to take care of your overall health. Luckily for us nowadays, when it becomes unsafe to drive, we can contact Lyft or Uber.

Dr. Jamie M. Totsubo, OD, is licensed to diagnose and treat glaucoma as well as prescribe drugs to treat ocular disease. She received her Doctorate of Optometry from UC Berkeley. Her optometry practice is located at 1826 Buchanan Street, Suite A in San Francisco’s Japantown. For more information, visit or call (415) 931-1903.

One response to “Vision and driving”

  1. Nancy Shoji,OD Avatar
    Nancy Shoji,OD

    Great article!

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