Cataracts and Driving: When Is It No Longer Safe?

Driving is a crucial skill that most of us perform regularly. From convenience to independence, it’s part and parcel of everyday life. But, of course, you do have to meet minimum vision standards to be safe on the roads.

Having cataracts and driving safely are not mutually exclusive. Because cataracts evolve so slowly—typically over years or decades, and with no symptoms for much of this time—as long as your vision remains within legally safe parameters, then hitting the road in your vehicle of choice is absolutely fine.

But it is important to understand how they can eventually impact your eyesight. Vision changes caused by cataracts occur gradually, so it’s not a case of being alright to drive today and then, bang! In a week or a month, you need to hang up your car keys…

The key to safe driving with a cataract diagnosis is to regularly and honestly perform self-assessments. This, along with regular eye checks and discussing any worsening issues with your eye doctor, is hugely important. They are the person who will ultimately determine the right time for your cataract surgery and all the visual restoration it will bring.

How Cataracts Can Affect Driving and Vision

There are three primary warning signs that your eyesight might be causing issues when driving.

1. Worsening glare and halos while driving: Cataracts prevent the free flow of light through the eye, causing refractive errors. This can cause you to see bright halos around light sources, particularly from oncoming bright headlights. This has become more problematic in recent years, as the use of LED bulbs in car headlamps has increased. This is one of the most common problems, with glare blinding vision for several seconds, even after the light has passed.
2. Reduced contrast sensitivity: This is when it becomes more difficult to distinguish shaded objects on a similarly shaded background. For instance, a grey or black car on a cloudy day or a pedestrian wearing drab clothing. In addition, it can make judging distances more problematic and perhaps cause issues with seeing road signs against the sky.
3. Your eyes become slower to adjust to changing light conditions: Such as driving from sunshine into a tunnel or parking garage. Your vision takes longer to adapt, meaning excessive seconds before you can see clearly again.

Problems night driving with cataracts tend to be what people first notice over time. You may even find that you unconsciously reduce or even stop driving in the dark or in low-light conditions. This is why it’s important for everyone, not only those with cataracts, to regularly and honestly assess their own driving abilities.

Legal vision requirements in the US differ from state to state, typically requiring a minimum of 20/40 in one eye (with or without eyeglasses or contact lenses) and adequate peripheral vision, The American Academy of Ophthalmology (AAO) advises caution over and above this, with anyone experiencing issues with glare, halos, blurriness, contrast sensitivity, or any other visual anomalies advised to have regular eye checks. This applies to all of us, with or without cataracts or other eyesight issues.

Monitor Your Vision Regularly with a Self-Assessment Framework

In addition to regular eye checks, using a self-assessment framework will help you realize if your vision is declining. It also provides you with hard data to report back to your eye doctor.

Keep a journal for a few weeks

• Did you alter journeys to avoid driving in the dark, dusk, or early morning?
• Did you experience headlight glare and need to slow down or take evasive action?
• Were there any moments when you couldn’t see clearly?
• Did you miss any crucial signs, road markings, or other road users?

Ask yourself honest questions

• Have you become more nervous or anxious when driving?
• Has anyone commented on your driving?
• Do you find you’re gripping the steering wheel more tightly or have you changed your driving position, such as leaning forward?
• Have you had any near misses?

Take an assessment drive with a trusted person 

• Can you read road signs at the same distance as they can?
• Can you see pedestrians, cyclists, etc., at dusk or dawn when they may not be using lights or have reflective clothing?
• Are you comfortable driving at night?

Taking such an approach is both responsible and will give you confidence. Having a deeper understanding of how your vision is will also help your ophthalmologist determine the right time for cataract surgery.

Cataract Surgery and Driving: The Road Back to Confidence

Cataract surgery has a virtually 100% success rate, restoring the flow of light through the eye, improving contrast sensitivity, addressing issues with glare, and reducing or eliminating halos while driving. Cataract operations are the most common surgical procedure in the world, with tens of millions successfully performed each year.

Knowing when to stop driving with cataracts is something that all of us need to be honest about. However, with early diagnosis and ongoing professional assessment for timely surgery means that this may not be necessary. Even if you’ve unconsciously stopped driving at night or are struggling with glare and halos, cataract removal typically means you’ll be able to rediscover and benefit from:

• Much improved contrast sensitivity and color perception. Not only will objects and distances become clearer, but colors become brighter and more vibrant, meaning you’ll enjoy the world in all its technicolored glory once again.
• Low-light and night driving become far easier. Glare issues and seeing halos reduce or go away altogether.
• A much-restored confidence in your driving abilities.

Cataracts and Driving Safely: FAQs

Q: Is it illegal to drive with cataracts?

A: In a word, no. However, it is illegal to drive if your vision doesn’t meet the required standard in your state (with or without corrective lenses). This is:

• Minimum of 20/40 in one eye
• Adequate peripheral vision (120-140 degrees)
• Plus, any other state-by-state requirements, such as depth and/or color perception.

Q: How bad do cataracts have to be to affect driving?

A: This is subjective, because even if your vision hits standard eye test targets, cataracts can still have a negative impact on driving vision, because it involves many complex visual tasks. Additionally, cataracts progress slowly—but sneakily—meaning that you don’t notice that you’re altering your driving habits. If you find that you’re driving less at night, sticking to familiar routes, or becoming overall more nervous or anxious about driving, then these are potentially signs that cataracts are affecting how you drive.

Q: When should I stop driving at night with cataracts?

A: The simple answer is when you can no longer drive safely and responsibly. For example, if you struggle to see clearly or you feel overly anxious when doing so. If you notice any emerging patterns, such as being blinded by oncoming headlights, avoiding driving during low-light, or preferring if someone else drives, then reducing or stopping night driving might be necessary. Communicate this to your eye doctor, as it will play a role in the decision as to when surgery should be performed.

Q: How soon after cataract surgery can I drive?

A: Many people are able to drive within a few days or a week of surgery. Of course, everyone is individual, and your personal timeline will depend on your individual healing in partnership with approval from your cataract surgeon.

If cataracts are affecting your driving, it may be time for a surgical evaluation. Dr. Bellotte sees patients from across Florida and beyond. Visit the Modern Cataract Surgery Clinic to book a consultation.