Bright Light Issues With Lithium

[gizmo]

I have an issue driving at night that I think is from the lithium. All the lights (street lights, headlights, store signs, etc) all have starlight beams shooting from them... think of a baby Jesus halo of light kind of thing. It's bad because I live in a big city, and all the lights together with the strobe effects make it almost impossible to see the lane dividers, the median barriers, etc. I don't really have any blurring of vision any other time - I do wear glasses, however.

Is this a lithium side effect? Is there anything I can do to fix this, other than stopping the med? It's been an important part of my cocktail for three years, but then again, I can't stop driving at night.

[nalgas]

Do you have the same thing happen looking at lights without the windshield between you and them and/or without your glasses on? Generally that kind of visual stuff is a physical thing (although it could be a brain thing, too), at least in my experience. If it happens with your naked eyes, that narrows it down to something going on with your vision (whether it's your eyes or something in your visual processing). It could very easily be a "feature" of your glasses or the windshield, though. If there's crud on them (even just residue from cleaning products), you can get all sorts of weird things happening under the right lighting conditions, and also over time the lenses/windshield can get very fine scratches that are pretty much invisible most of the time but are glaringly (no pun intended) obvious with certain lighting. I have all sorts of bizarre distortions and halos and stuff like what you describe because of my weird corneas, but it's noticeably worse looking through some windshields at night, and if I move my head around, it lines up exactly with the path the windshield wipers travel along (as they drag little bits of junk back and forth across the glass, of course).

So, uh, maybe? There are lots of reasons you could be seeing stuff like that, and various meds can make people more sensitive to light, which would make you notice things you didn't before or make them more of an issue. It could take a little work and paying attention to when it happens more/less (if it is different at different times) to figure out where it's coming from.

[AirMarshall]

Lithium makes the eye less sensitive to light. One result of this is that the iris does not respond ideally to the light level. During the day, this means the iris does not close down adequately, allowing too much light. The danger is of excess UV exposure, and various sources recommend that users wear sunglasses outside.

At night, the consequence of being insensitive to light is a slight decrease in night vision.

I'm not sure that explains the starburst effect. Frankly, over the last couple years I'm finding it harder to drive at night, but then I've also gone to bifocals and turned 49. If I find anything more I'll post.

best, a.m.

[crazydiamond]

Have you ever had LASIK to correct nearsightedness? Or any other eye surgery?

Years ago, starbursts used to be a some-what common side effect for people who underwent LASIK and had large pupils. This was due to some limitations of the laser and technique at the time, and these have been largely compensated for so these side effects aren't as common. Anyway, before the surgery, a person's pupils are measured so they know where to laser, and this ensures clear vision. But if the lithium is affected your pupil size (thanks a.m. for pointing this out, I was not aware of it), it's possible that there is a mis-match in sizes between the part that was lasered and your pupil size, leaving you with the dreaded starbursts that many people have to live with on a permanent basis.

Clear as mud? I hope that I explained that ok.

[iwilltake2]

I have that issue, but Li is not the cause, astigmatism the eye doc said. Really annoying

[AnneMarie]

Gizmo, I use night driving shades. They basically are light sensitive sun glasses that lighten to almost but not quite clear at night. They also are anti-glare. These help tremendously. I had this problem before psych meds and it has gotten worse over the last few years. Might be meds. Might be age. Might be both. At any rate, I am comfortable driving at night with them whereas I have a bit of a hard time without. If you have insurance coverage for eyeglasses, the price isn't so bad, but they are not the cheapest glasses you'll buy. Still, for me, they have been a good investment.

[scatty]

I know what you mean gizmo. I can hardly read my onscreen tv guide after taking lithium. It's all doubled up, much like you described with the street lights. My pdoc asked if I wanted off lithium, but it's been a life saver for me. He said it was nothing permanent.

[gizmo]

Thanks to everyone who replied to my post. I'll try to answer some of the really great thought-provoking questions.

Nalgas - I see these starbust effects looking at bright lights with the naked eye with no glass interference as well - i.e. not looking through my glasses or through the windshield. Though your idea did make me stop and go outside and look at my street lamps without my glasses, lol.

AM: my eyes have turned "weird" as I've gotten older. The last time I was at the doctor, he actually lessened my prescription because if I focus hard enough, I can almost as clearly without the glasses as I can with them. Of course, it's difficult to focus for 5 seconds on a moving target on the street, hence the glasses. The glasses vs. none otherwise are 6 of one, half dozen of the other. Meh.

crazyleila: I've never had eye surgery, but thanks for the in-depth reply.

iwilltake2: very interesting. I will take this to the eye doctor. I had astigmatism as a youth, but apparently it went away. Perhaps it did not?

Stacia: another thing I didn't know about. I'm going to have to check those out. So are they prescription lenses, or are they just regular sunglass lenses that fit over your existing eyeglasses? I'm going to have to do an online search. Thanks for the info.

Scatty: I'm sorry your vision has doubled. My vision during the day is ok (well, as ok as it gets, lol). It sucks when you have to choose between a med that works and a side effect that you can't stand.