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Poor Night Vision After Cataract Surgery

For anyone with poor night vision related to cataracts, cataract surgery can feel like the light at the end of a long, blurry tunnel. But sometimes, seeing clearly at night is still challenging, even after the surgery.

Night vision problems don’t always disappear right away. In some cases, they even emerge for the first time after surgery—a frustrating twist, no doubt.

However, while these issues are common, they often get better. With today’s cutting-edge lenses and precise surgical techniques, clearer night vision is more achievable than ever.

Why Do Cataracts Affect Night Vision?

Cataracts cloud the natural lens of the eye, almost like looking through frosted glass. When clouded by cataracts, the light seen through the natural eye lens scatters in all directions instead of passing straight through.

The result is chaotic glare, halos, and shadowy distortions—headlights become blinding, streetlights have glowing rings, and walking through dim spaces feels uncertain and disorienting. Per the Journal of Ophthalmic and Vision Research, night vision significantly deteriorates as cataracts progress. So, does cataract surgery improve night vision? Keep reading to find out.

How Does Refractive Cataract Surgery Improve Night Vision?

Refractive cataract surgery replaces your eye’s cloudy natural lens with a crystal-clear artificial one, allowing light to pass through cleanly and focus precisely on your retina.

Modern lenses can deliver sharp, clear vision during the day and maintain clarity after dark. The following are types of artificial intraocular lenses (IOLs) that can correct blurry vision.

• Monofocal IOLs: These lenses provide crystal-clear distance vision and help reduce nighttime blur.
• Aspheric IOLs: Ideal for minimizing glare and halos in low-light conditions, enhancing overall visual clarity.
• Toric IOLs: As designed to correct astigmatism, toric lenses offer sharper edges and significantly fewer distortions.
• Extended Depth of Focus (EDOF) IOLs: This type of IOL is perfect for those seeking seamless focus across a range of distances with minimal night glare.
• Multifocal Lenses: These IOLs help users switch between near, intermediate, and far vision, improving night-driving confidence and visual adaptability.

Common Post-Surgery Night Vision Challenges

If your night vision seems worse after cataract surgery, don’t panic. Effects like glare, halos, or nighttime blurred vision are common during the early stages of recovery. Your eyes are adjusting to their new lenses, almost like learning how to see all over again.

You might also experience light sensitivity. After cataract surgery, your pupils may react differently in low-light conditions, making night driving or even a simple evening walk more challenging. The good news is that these symptoms are usually temporary. Most people notice significant improvements within a few weeks, and the dazzling light shows typically disappear within a few months. Before long, your night vision will likely be sharper and clearer than in years.

Factors that Influence Night Vision Improvement

Everyone heals differently after cataract surgery, and several vital factors influence how quickly you see improvements. They include:

• Type of IOL Chosen: Because every lifestyle and set of visual needs is unique, selecting the right IOL can make everyday activities—from reading to driving at night—clearer, sharper, and more comfortable. Monofocal and aspheric IOLs are especially effective at improving night vision quality by minimizing glare and enhancing contrast sensitivity.
• Eye Health and Pre-Existing Eye Conditions: Underlying issues like macular degeneration or diabetic retinopathy can affect the health of the retina—which is the part of the eye essential for clear vision—and limit your surgery’s full potential.
• Surgical Precision: Advanced laser-assisted techniques allow cataract surgeons to position your IOL with pinpoint accuracy. Better alignment means fewer visual disturbances and improved clarity, during the day and at night.

Tips for Improving Night Vision After Cataract Surgery

Choose the Right IOL for Your Lifestyle

Consult with your ophthalmologist to find an artificial lens that matches your daily needs, whether driving at night, reading, or working on a computer. Aspheric IOLs, for instance, reduce nighttime glare and halos better than traditional lenses. Some patients even complement their IOLs with contact lenses to further improve their vision.

Follow Post-Surgery Care Guidelines

Adherence to a recovery plan will significantly improve the quality and speed of your night vision recovery. Here are some post-surgery guidelines on accelerating the healing process.

• Avoid bending over, lifting heavy loads, or strenuous exercises that put extra pressure on your eyes.
• Drink plenty of water to maintain your eyes’ moisture balance and support healthy tissue.
• Take all prescribed medications to minimize swelling and prevent infection as your eye heals.
• Attend all follow-up appointments to allow your doctor to monitor recovery, adjust your care plan if needed, and address any early issues before they escalate.

Manage Lighting Conditions

Even after the eyes have healed, many patients notice that bright lights, like headlights, street lamps, or neon signs, feel harsh or cause distracting halos when driving at night.

Anti-glare glasses minimize the amount of light bouncing off the lenses. Instead of scattering light into your eyes, the anti-reflective coating allows more light to pass cleanly through, sharpening your view and reducing strain.

You can also adjust your home lighting by choosing warm, low-intensity bulbs, installing dimmers, and replacing glaring overhead lights with accent lighting.

Realistic Expectations for Night Vision Improvement

A study published in the Journal of Cataract & Refractive Surgery reported that patients implanted with aspheric IOLs experienced a 43-100% improvement in mesopic (low-light) contrast sensitivity, and up to a fourfold increase in retinal image contrast compared to those with spherical IOLs.

Furthermore, a randomized, observer- and subject-masked study demonstrated that aspheric IOLs improved contrast sensitivity and the ability to drive safely at night compared to spherical IOLs. Patients with aspheric IOLs showed significant improvements in detecting road signs and pedestrians under various driving conditions, including glare and fog.

However, it’s important to note that people with significant corneal or retinal diseases may not experience the same level of improvement. Eye diseases such as corneal scarring, macular degeneration, or diabetic retinopathy can limit the benefits of aspheric IOLs, as these underlying issues affect overall visual quality, including night vision.

Will Cataract Surgery Improve Night Vision? | Expert Insights and Scientific Citations

1. American Academy of Ophthalmology on Monofocal Intraocular Lenses (IOLs)

The American Academy of Ophthalmology discusses the benefits of monofocal IOLs, particularly the Johnson & Johnson Tecnis Eyhance lens. This lens provides excellent distance visual acuity and functional intermediate vision.

Monofocal IOLs also improve vision in low-light conditions without the glare or halos commonly associated with other lens types; this makes it especially beneficial for patients who require clear vision under dim lighting, such as during night driving.​

2. British Journal of Ophthalmology on Driving Performance Post-Cataract Surgery

A study published in the British Journal of Ophthalmology examined the effects of bilateral cataract surgery on driving performance. The research involved 29 older patients with bilateral cataracts and 18 control participants with normal vision. The researchers assessed all participants’ driving capabilities on a closed-road circuit, but the patients were tested twice, once before and after cataract surgery.

The study found that patients had significantly poorer driving performance before surgery than controls. However, after undergoing cataract surgery in both eyes, their driving performance improved significantly, matching the level of the control group. This dramatic improvement is attributed to enhanced contrast sensitivity and reduced glare sensitivity post-surgery, critical factors for safe night driving.

Your Journey to Clearer Vision Starts Here

Cataract surgery can be a life-changing procedure for those struggling with blurry, distorted night vision. Whether you’re considering multi-focal lenses, contact lenses, or advanced IOLs to replace your eye’s natural lens, you don’t have to navigate your options alone. Contact Young H. Choi Eye Surgery Center for more confident night vision.