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Why can I See Perfectly Well During the Day but Not at Night?

I'm afraid I'll fall because I can't see in the dark.

Night blindness- for many people, it's a normal aging process that happens gradually. If you're 40 or older, you may already be experiencing the first effects of night blindness caused by fewer light-sensitive rods, yellowing of the lenses, and slower and less dilation of the pupils, all of which reduce the amount of light reaching the retina. You may have no problem seeing in daylight, but everything is out of focus at dusk, at night and in poorly lighted rooms and restaurants (can't read the menu). Road signs are difficult to read when driving. For many people, corrective lenses can overcome the adversities of night blindness and restore confidence in traveling at night or in unfamiliar, poorly lighted places.

However, for many adults 65 and older, low vision - vision loss that can't be corrected with surgery, medication or lenses- is a major factor contributing to falls in the dark due to loss of depth perception (3-dimensional vision) and inability to see colors, edges, and changes in surface textures, all of which increase their risk of falling.  Low vision can cause complete blindness at night.

Night blindness is also a side-effect of eye diseases that are increasingly common in older adults, including macular degeneration, glaucoma, cataracts, and diabetic retinopathy. Perhaps less well known is that low vision is also caused by a number of other chronic medical conditions such as hypertension, Parkinson's Disease, Vitamin A deficiency and autoimmune disorders including Lupus, multiple sclerosis (MS), psoriasis, and rheumatoid arthritis (RA). Many people, including more than half of adult diabetics, do not understand the risk of blindness due to diabetes.  Diabetic retinopathy is the leading cause of blindness in middle-aged Americans.  

If you can see well at night, with or without correction, it may be difficult to put yourself "in the shoes" of someone who is night blind due to low vision. What is it like being Night blind? , an online post and video, told in the first person, will give you an idea of what life is like for someone unable to see in the dark.

Normal Night Vision

Night Blind - Low Vision
Fortunately, for many people, impaired night vision can be improved with additional light. Just as the small print on the menu is easy to read in daylight, night vision when traveling can be augmented with the addition of bright, directed light in the walking area to illuminate obstacles in the travel path.  Lighter environments favor central vision, which provides the greatest color and contrast sensitivity, acuity (focus) and depth perception.

If you or a family member have trouble seeing in low lighting, make an appointment for an eye examination with an ophthalmologist or optometrist. Your eye care professional can diagnose vision problems and help make the most of your vision at night.

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