I have an early cararact patient suffering from glare from lights and headlights at night. Are there any lenses I can recommend? She has polarized Grey C, but is still complaining about glare during the day. Any lense available to cut glare for nighttime driving. Thanks in advance.
Regards,
Judy
"Do something that scares you everyday." Eleanor Roosevelt
Does the patient wear glasses to drive at night? If so do the lenses have an antireflective coating on them?
We've had some luck with Hilco clip-ons with enhancer lenses. Pg. 67-68 in the January 2013 Hilco catalogue. Suffix 3000 when you order the clip.
Not too expensive for the pt. We tell them: "If you want, roll the dice. When they work they're worth every penny. If they don't help that much, you're not out a boat load of money."
It's important that the client understands that it's normal to have poor night vision with most types of cataracts. Manage expectations. Providing an optimal Rx and lens design may improve the acuity and visual comfort, but the glare is inherent in the eye system, and will remain and possibly worsen until CAT SX.Originally Posted by judyseyes
Tinting is not recommended for driving at night. Amber/brown will probably be very helpful for daylight outdoors compared to grey.
Although not directly related to the above, here's a nice explanation of why folks over about age 50 complain about their night driving vision.
http://www.health.harvard.edu/newsletters/Harvard_Womens_Health_Watch/2007/June/Blinded-by-the-night
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
Also, simply cleaning the inside of their windshield can reduce night driving glare.
[QUOTE=Robert Martellaro;472070]It's important that the client understands that it's normal to have poor night vision with most types of cataracts. Manage expectations. Providing an optimal Rx and lens design may improve the acuity and visual comfort, but the glare is inherent in the eye system, and will remain and possibly worsen until CAT SX.
The thinking in this business seems to be that cataracts and cataract surgery are inevitable, but I wondered why some people get them and some don't. I did research for a patient with a similar problem with cataracts and glare, and found that cataracts can be reversed. I guess it is a process of trial and error, but replacing nutrients in which the cataract suffer is deficient is one way. Also if a person has heavy metals, chelation therapy can help. Dr. Kondrot in Florida recommends a diet of living organic foods, and the avoidance of GM foods, any kind of prervatives, and corn fructose. He also sees dehydration as a culprit, because cataracts are denatured lens proteins. Increasing glutathione is also recommended, to be done with supplements of N acetyl-cysteine. There's a lot of information out there that appears credible. It seems to me that there should be a preventive aspect to what we do.
Agree with that big time. I hate! With a passion I HATE to clean the inside of a windshield. The only way mine gets attention I notice how bad it is if the window get foggy by then its a mess and driving at night is horrible. The windshield is at such a awkward angle is the only reason I hate it so much.
But I can see where a dirty windshield inside could annoy some one with a developing nuclear sclerosis.
No studies have proved how to prevent cataracts or slow the progression of cataracts.
If you live long enough.The thinking in this business seems to be that cataracts and cataract surgery are inevitable,
Science is a way of trying not to fool yourself. - Richard P. Feynman
Experience is the hardest teacher. She gives the test before the lesson.
Being a happy post cataract case, I went through the 15 minute operation, twice 2 years apart, got the implant and paid $ 199.00 for all of it each time. That is our Canadian medicare, the Naples Ophthalmologist wanted $ 4,000.00 for each eye, done in his in house clinic .
Before it all started I became light sensitive, started to wear a base ball cap and reverted to my old blue-blocker glasses which seemed to be the most comfortable ones of all of them.
The pre operation time is the one that is the most annoying period, but the higher licht sensitvity has stayed on, while the vision is back to normal or better.
Well...there certainly is no panacea for preventing cataract formation...except, "don't get old".
Like with so many other conditions in life that you want to prevent...eat right, exercise, and take anti-oxidant supplements (maybe).
And, oh yeah, somewhere in Florida is the Fountain of Youth...Go drink from it every winter.
There is basically no spectacle lens that can make up for night time driving glare associated with cataract formation.
The glare that your patient is experiencing is common for cataract patients. The changes in the cortical structure of the crystalline lens is causing the glare, which is improved by filtering out blue light. That is why Robert Martello is recommending brown sun lenses. A brown with more yellow base rather than blue base is best. AR is really the only help at night, and I truly agree with clean windshields, as ANY film/dirt/grease can produce glare on the windshield. The LED headlights are producing more glare, so tell them to look away from them. Has anyone done any research on any of the AR's introduced for reducing blue light on the market today?
Diane
Anything worth doing is worth doing well.
Does the wearing of contact lenses hasten the development of cataracts?
Actually there is quite a bit of exciting research going on, though most involves canines. Several studies have shown that 1% drops of N acetyl-carnosine is effective at prevention and can also dissolve cataracts in canines, which have formed due to damage from oxidative stress in lens epithelial cells.
http://www.ncbi.nlm.nih.gov/pubmed/24093642
I think it's safe to say, "nahhhhhhhhh". What makes you ask though?
The answer is yes, the patient's rx is -2.00 -1.00 x 90 and she does wear Purecoat
Regards,
Judy
"Do something that scares you everyday." Eleanor Roosevelt
I hear people complaining about things like eyes feeling hot all night after wearing CLs all day long, which makes me think those eyes are under a tremendous amount of stress. Obviously not good, but does this contribute to cataract formation?
And what about the stress induced by oxygen deprivation in those wearing lens that do not have a high oxygen transmission value?
Vistamesh should work.
Then my suggestion would simply be pt education about the effects of cataract on vision (reduction in clarity due to reduced light, increased glare, changes in the appearance, quality of colors, etc.) and reducing the things that cause glare (making sure her glasses are clean, making sure her windshield is clean). I do not recommend a clip on, because I am concerned about the chances of increased glare from the light bouncing between the front of the eyeglass lens and the back of the clip.
I've never heard a CL patient complain about a hot feeling, but in any event, CLs can possibly cause corneal damage, but I have never seen a case of cataracts where CLs were under suspicion. No studies have raised this as a possibility.
We have successfully helped refractive surgery and others with glare issues with Transitions Vantage, Carat Advantage AR using a non-compensated digital lenses. Another color that works well for those developing cataracts is a Plum 20% tint.
Bev Heishman, ABOM, NCLC-AC
Some things to know about cataracts: 1) There is no verifiable scientific study that has demonstrated any reasonable method of delaying the onset of or reversing cataracts in human beings 2) Cataracts are a result of the natural process of the lens of the eye in which it is continually hardening since birth until it is no longer flexible(usually in our 40's; also known as Presbyopia). Eventually the lens begins to cloud(generally early 60's) and it changes name and is then called a cataract. 3) Contact lens wear and the permeation of oxygen through the cornea has ZERO effect on the growth of a cataract. 4) While most cataracts are the result of the natural aging process people may also develop cataracts due to trauma; following certain surgeries within the eye; people are sometimes born with them(congenital cataracts). There is no cure for cataracts, the only way to resolve them is by removal through surgery and the implantation of an artificial lens. All that being said, the best way to accommodate increased glare in a patient with cataracts is providing them the best refraction possible and a pair of spectacle lenses with a quality anti-reflective coat. While tints at night are not advised, very light amber tints can mitigate the brightness of lights. The main problem is that there is glare being created within the eye by the lens that is clouding and there is no coating or tint that will offset that.
I agree with everything you say. There is a bit of evidence that anti-oxidants can delay the onset of cataracts as they similarly delay other changes related to ageing. Certainly not a panacea, certainly cannot reverse cataracts, but worth considering for good overall general health and SLIGHTLY delayed ageing.
Blu Blocker color is best for these patients
B
All well and good for the tints...but not for night driving.
If a person is experiencing that much interference...
1) I would query about the expected acuity,
2)...approximate surgical date,
3) and arm them with 65% Zeiss umbral non polarized lenses for daytime comfort.
4) I would also suggest that someone else do the driving at night for her..... until post surgical times.
Eyes wide open
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