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Blurriness, Reduced Contrast Sensitivity, Glare Sensitivity, and Night Blindness

The following article addresses the following types of low vision deficits: blurred vision, reduced contrast sensitivity, glare sensitivity, and the problems of “night-blindness”.

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In many cases symptoms such as blurred vision, night blindness and reduced color contrast are caused by degenerative diseases such as diabetic retinopathy, retinitis pigmentosa, inoperable cataracts, glaucoma, and age-related macular degeneration.  However due to the complexity of the visual system there are many other potential causes for these symptoms, which is why we always recommend a comprehensive eye exam to assess the cause of those symptoms. When scheduling the eye exam, make sure to discuss the symptoms and when they occur with your optometrist. 

If you are experiencing severe symptoms we recommend visiting a low vision optometrist who not only has the capabilities to detect the condition but also to implement appropriate interventions to maximize remaining eyesight and enable an active life. Interventions include the use of specialty devices and rehabilitation therapy.

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What Are The Causes And Challenges Of Blurred Vision, Reduced Contrast Sensitivity, Glare Sensitivity, and Night Blindness?

All of these types of low vision deficits may be caused by a variety of factors, including diabetic retinopathy, macular degeneration, inoperable cataracts, glaucoma, refraction errors of the eye, or traumatic injury.

Due to the complexity of the visual system, there are a wide range of conditions that may cause these symptoms including: 

  • Optic neuritis
  • Stroke
  • Retinal Detachment 
  • Macular Hole 
  • Temporal arteritis
  • Uveitis
  • Optic Nerve Disorders/Multiple Sclerosis
  • Traumatic Brain Injury 
  • Usher Syndrome
  • Nystagmus 

Less severe causes: 

  • Corneal abrasion 
  • Ocular Migraine 
  • Conjunctivitis/Pink Eye
  • Iritis 
  • Keratitis
  • Complications after LASIK or refractive surgery 
  • Vitamin A deficiency 
  • High Myopia or Astigmatism

Blurred Vision

  • How It Presents: Manifests as out of focus vision, regardless of the distance.

How It Can Impact You: It isn’t always easy to detect, and may occur so gradually that the person doesn’t realize the deficiency. This is why routine testing is critical to ensure early detection and intervention before the condition worsens. Blurry eyesight prevents people from being able to focus on objects, regardless of distance.

  • Recommendations: Speak with a low vision optometrist to discuss vision rehabilitation that might aid this condition.

Reduced Color/Contrast Sensitivity

  • How It Presents: This deficit affects the quality of images, which may appear hazy or cloudy. Some colors are more suitable for those with color sensitivities.Contrast reflects the ability to discern differences between light and dark areas.  Effective usage of color enhances the ability to discern contrast.
  • How It Can Impact You: It can affect safety, since it may be difficult to detect certain colors or contrast found on warnings or other signs that are designed to indicate possible hazards. 
  • Recommendations: Use bright, solid, colors that reflect light effectively and are more visible, for improved safety and convenience. Colors can provide safety cues in hazardous environments or in the home, as well as enhancing convenience with various systems of color-coding.

Sensitivity to Light

  • How it Presents: Brain injury is often accompanied by increased light sensitivity and a general inability to tolerate glare. Photophobia, or sensitivity to light, can be exacerbated by certain light sources, such as bright sunlight and fluorescent lighting. Recent studies suggest that LCD screens (such as from computers or smartphone devices) can be particularly bothersome following a concussion. 
  • How It Can Impact You: Living with discomfort/pain from lighting and glare can be difficult and inconvenient. 
  • Recommendations: Using full spectrum lighting or lighting with a high Color Rendering Index (CRI) to provide effective illumination that doesn’t cause eye strain.

Night Blindness

  • How It Presents: Difficulty in seeing faces or objects at nighttime or under low light conditions. Additional signs of impaired night vision include: complete blindness in dark conditions, the appearance of “halos” and “streaks” when looking at light, light and glare sensitivity or discomfort, blurriness in poorly lit environments or nighttime, and difficulty in driving.
  • How It Can Impact You: The inability to see under low-lit conditions can make life difficult and dangerous. The dangers of people driving with visual impairment from night-blindness is apparent. Additional hazards include the added likelihood of tripping and sustaining injurious falls in the home under poorly lit conditions.
  • Recommendations:There are small but effective hand-held lamps available today that can be used to assist people under low light conditions. Drivers can have their friends and families drive them places during nighttime hours. 

It is imperative that people with night-blindness utilize full spectrum lighting and lighting with a high Color Rendering Index (CRI) throughout their home to ensure a safe environment. Lighting should be strategically placed to maximize illumination. Use timers to ensure that the lighting comes on at the same time everyday.

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What Does A Low Vision Eye Exam Look Like?

What Does A Low Vision Eye Exam Look Like?

During the exam, a low level optometrist will inquire about the patient's medical history, the nature of the visual difficulties, and how it impacts daily life. There are many tests for visual acuity and visual field to assist in a diagnosis. A thorough interview and physical exam allows the doctor to formulate a vision care plan for living with this condition.

What Interventions Are Available?

Low vision is irreversible. Routine eye exams are important for detecting and monitoring complications so that early interventions can be implemented. Low vision optometrists help patients maximize remaining eyesight by incorporating visual aids (both optical and non-optical), assistive technologies, and rehabilitation therapy. 

  • Optical devices: Specialty glasses, prisms, filters, telescopic devices, binoculars, and other visual devices are used to improve deficits.  Using tinted glasses and anti reflective lenses are a highly effective, inexpensive, way to improve contrast sensitivity.
  • Magnifiers: There are many types of magnifiers available, from small hand-held models, to powerful electronic magnifiers. CCTV devices project magnified images on a monitor. They are useful for color contrast sensitivity.
  • Lighting: Proper lighting options should be full spectrum or high in the Color Rendering Index (CRI), which makes it easier to see colors and improve color contrast sensitivity. 
  • Rehabilitation: Rehabilitation therapy teaches strategies and techniques for maximizing remaining eyesight and learning skills which enable people to lead normal lives. Treatment may involve co-management with an occupational therapist. 
  • Assistive technologies: These include speech-to-text, text-to-speech, voice activation software, software for contrast adjustment, and computer screen readers.

Proper use of digital devices: By properly using settings on hardware devices, people can benefit from the appropriate level of brightness, contrast, lighting, and magnification that matches their needs.

You Can Enjoy A High-Quality Of Life

Difficulty with contrast, glare and light sensitivity, and night blindness can cause major distress and difficulties to a patients life. Oftentime,  standard interventions such as glasses and contact lenses aren't effective. Thanks to the many available interventions today to deal with visual deficits, people are engaging in daily activities and living enjoyable lives. 

If you are experiencing symptoms of blurry vision, night blindness, glare, or contrast sensitivity, schedule an exam with our low vision optometrist to find out more about the many available options for improved living.

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Common Questions

Using a good antiglare coating will help reduce glare. Some are formulated better than others which will determine how much glare is reduced. There are varying models and levels of antiglare from a variety of companies. Do a little research and find out which one will work for you.
Reduced contrast sensitivity refers to the diminished ability to distinguish between objects and their background when there's little difference in brightness or color. It makes it challenging to see subtle differences in shades or textures. A low vision exam by a low vision optometrist can assess contrast sensitivity and provide strategies or tools to enhance visual perception. It's a vital aspect of vision that affects daily activities, like reading or recognizing faces.
Poor vision at night or difficulty seeing in low-light conditions is referred to as night blindness, or nyctalopia. It could be a symptom of underlying eye conditions, such as retinitis pigmentosa or vitamin A deficiency. Consultation with a low vision eye doctor can help diagnose the root cause through a comprehensive examination and guide appropriate treatment or adaptive strategies.
Glare and photophobia are related but distinct. Glare refers to difficulty seeing in the presence of bright light, often causing discomfort or reducing visibility. Photophobia is an abnormal or excessive sensitivity to light, where even normal levels of illumination can cause discomfort or pain. A low vision exam may help in understanding the specific issue and provide tailored solutions, as both can significantly impact daily functioning.
Contrast sensitivity involves the ability to detect differences in luminance between an object and its background. An example might be distinguishing the facial features of a person standing in front of a similarly colored wall. Reduced contrast sensitivity might make this differentiation challenging, particularly in dim lighting. A low vision optometrist can evaluate contrast sensitivity and provide tools or strategies to improve this aspect of vision, enhancing overall quality of life.
Blurriness, Reduced Contrast Sensitivity, Glare Sensitivity, and Night Blindness
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Blurriness, Reduced Contrast Sensitivity, Glare Sensitivity, and Night Blindness

In many cases symptoms such as blurred vision, night blindness and reduced color contrast are caused by degenerative diseases such as diabetic retinopathy, retinitis pigmentosa, inoperable cataracts, glaucoma, and age-related macular degeneration.  However due to the complexity of the visual system there are many other potential causes for these symptoms, which is why we always recommend a low vision eye exam to assess the cause of those symptoms. When scheduling the eye exam, make sure to discuss the symptoms and when they occur with our low vision optometrist. 

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