Difficulty focusing and blurry vision even though 20/20

[ameneses]

First of all, thanks for the replies.
I'm 63 nearsighted most of my life and have amblyopia. About a year ago I've been experiencing blurry vision, difficulty focusing particularly at night. Also, night driving is very annoying as the glare of headlight really bothers me. All this is compounded when I have limited sleep and tired--it seems that lubricating eye drops help somewhat.
As my optometrist's prescription corrects to 20/20, I went to the ophthalmologist who found nothing particularly wrong except very incipient cataracts (the optometrist also said the same thing)/
Even though I'm happy that nothing major is going on night driving has become very stressful.
Any ideas?

[JohnHaganMD]

At 63 the most likely cause is the cataract even if "incipient" if you did not have this 5-10 years ago.  Pull up some images of early cataracts and compare them with a clear young lens and you will see how they cause blurred vision. Night vision problem is the #1 symptom by far of "early", "Tiny", Incipient, "baby" cataracts.  Those diminutive terms do not mean it doesn't cause symptoms and one reason why night workers,  truck drivers and commercial pilots often have to have these small cataracts removed.

[ameneses]

Thanks for your reply.
Would your reasoning apply even if I see quite well during the day or in the optometrist's office?

[JohnHaganMD]

I am seeing patients today. This morning I had several people with small cataracts that read 20/20 in my office but complained of glare at night. There is an instrument called a 'glare tester" is simulates night vision. When we test these people with the glare tester their vision dropped to 20-50-20/200.  So either the optom or the ophthalmologist should do glare testing if they have the appropriate instruments.

[NightHawkGuy]

That "glare tester" instrument sounds fascinating! How exactly does it work to simulate night vision?
Would it be able to detect other types of night vision issues besides glare?

[JohnHaganMD]

Link to glare testing article:  https://www.eyeworld.org/article-glare-testing