Halos, Glare and Night Driving:

How a New Generation of Cataract Lenses Is Changing the Picture By Dr Mark Deist, Sandhurst Eye Centre, Johannesburg

If you are facing cataract surgery and hoping to be less dependent on glasses afterwards, you have more lens choices today than ever before — and probably more questions. Alongside the promise of “premium” lenses comes a concern many patients raise in the consulting room: what about night-time halos, glare and starbursts around lights?

These visual effects — known collectively as photic phenomena — are the number-one reason patients are dissatisfied with premium lenses, and they matter most when it matters most: driving at night.

The good news is that lens technology has taken a significant step forward. Two recently introduced lenses — the TECNIS PureSee and the RayOne Galaxy — take a fundamentally different approach that was specifically designed to minimise these effects.

Here is what you should know, in plain language.

What are halos, glare and starbursts?

Around any point of light — a headlamp, a streetlamp, an oncoming car — three different effects can appear:

●        Glare (flare): a soft, hazy spread of light around the source.

●        Halo: a ring of light encircling the source.

●        Starburst: radiating spikes, like a star, around the source.

Glare, halo and starburst — the three visual effects patients most often notice around lights at night.

All three are most noticeable in dim light, when your pupils open wider — which is exactly the situation you face behind the wheel at night. How much you notice them depends largely on how your lens handles light.

Why do some premium lenses cause rings of light?

Traditional multifocal and trifocal lenses use tiny concentric rings — diffractive optics — to split incoming light between different focal points, so you can see far and near without glasses.

That design comes with a built-in compromise:

●        About 11% of incoming light is lost to scattering, which reduces contrast (the crispness of what you see).

●        The rings create structured ring-shaped halos that actually become larger as your pupil dilates in the dark — the opposite of what a night driver wants.

●        Adapting to these rings (what doctors call neuroadaptation) can take months, and some patients never fully adapt.

For many people this trade-off is acceptable. But for others — especially regular night drivers — it is the deal-breaker that keeps them from choosing a premium lens.

The new approach: lenses without rings

Both the TECNIS PureSee and the RayOne Galaxy are purely refractive lenses.

Neither uses diffractive rings. Instead, each bends light with a smooth, continuous change in lens power — no rings, no light-splitting steps. Three practical consequences follow:

●        All incoming light reaches your retina — approximately 0% is lost to scattering, so contrast is preserved.

●        Any residual halo is small and purely optical in nature — not a structured ring.

●        Adaptation is fast — typically three to six weeks, not months, because your brain does not have to “learn to ignore” ring patterns.

In short, they behave much more like an enhanced version of a standard single-focus lens, while still giving you an extended — in the Galaxy’s case, nearly full — range of vision.

TECNIS PureSee: the night driver’s lens

The TECNIS PureSee is a purely refractive extended-depth-of-focus (EDOF) lens with a smooth surface and no diffractive rings. It delivers excellent distance and intermediate (arm’s-length) vision, with functional near vision to about 50 cm — comfortably covering dashboard, computer and most everyday tasks.

The numbers from clinical trials are striking:

●        88% of patients said they never, rarely or only sometimes noticed halos, and 100% said the same for glare. Across all visual symptoms, the maximum “bothersome” rate was just 3.4%.[1]

●        97% of patients said they would recommend the lens to family and friends.[1]

●        About one in eight patients may notice a mild halo on occasion — one that typically fades within three to six weeks.

The PureSee received FDA approval in March 2026 — notably, it is the first EDOF lens cleared without a contrast-sensitivity warning on its label.[2] A toric version is available for patients with astigmatism.

Most compelling for night drivers: the PureSee’s halo actually shrinks when your pupil dilates in the dark — the exact opposite of ring-based lenses. Measured objectively, the halo is 29% smaller at a typical night-time pupil size than in bright light.[3] For patients who drive at night, that is powerful reassurance.

RayOne Galaxy: near vision, without the rings

The RayOne Galaxy uses an AI-designed spiral refractive surface — a continuous power gradient with no steps and zero diffractive light loss. Released commercially in January 2025, it aims not just for extended, but for full-range vision, including stronger near (reading) vision than an EDOF lens:

●        On standardised testing, it maintained 20/25 vision or better from distance all the way to 40 cm.

●        Binocular near acuity reached 20/22 at about 35 cm — normal reading distance.[5]

●        In the first peer-reviewed clinical study (published November 2025), half of all patients reported no visual disturbances at all — no halos, no glare, no starbursts. The remainder reported only mild, non-bothersome symptoms, and no patient reported severe symptoms.[5]

The Galaxy’s visual profile is also independent of pupil size, and it has been specifically validated in eyes that have previously had LASIK or SMILE laser vision correction, with no increased visual disturbances.[6]

It is not yet FDA-approved, but it is CE-marked and available in South Africa. As a newer technology, its evidence base is less mature than the PureSee’s — something to weigh up during counselling. A toric version is also available.

How clearly each lens sees at every distance. Both new lenses cover the range most people use in daily life, without the light-splitting optics of older multifocal designs. (Clinical data from published sources.[1,3,5])

How do the two lenses compare?

No direct head-to-head trial has been published yet, but the clinical data available allow a meaningful comparison:

	TECNIS PureSee	RayOne Galaxy
Visual disturbances	88% never/rarely/sometimes notice halos; 97% would recommend	50% report zero disturbances; 0% severe
Night driving	Halo shrinks as the pupil dilates in the dark (−29%)	Profile unaffected by pupil size
Near vision	Functional to ~50 cm	Stronger: 20/22 to ~35 cm
Track record	Multiple randomised trials; FDA-approved March 2026; 289-eye multicentre study	First peer-reviewed study November 2025; CE-marked
Previous LASIK/SMILE	Not specifically studied	Specifically validated — no extra risk
Astigmatism correction	Toric version available	Toric version available

Both represent a clear improvement over conventional diffractive multifocals for night vision: no diffractive light loss, no enlarging ring halos, no contrast-sensitivity warning, and adaptation in weeks rather than months.

Which lens might suit which patient?

Every eye is different, and the final choice is always made together with your surgeon after detailed measurements. But broadly:

●        You drive at night often and want the strongest proven track record: the PureSee’s FDA-level evidence and shrinking night-time halo make it a natural fit.

●        You want the best possible reading/near vision without diffractive side effects: the Galaxy’s stronger near performance stands out.

●        You’ve previously had LASIK or SMILE: the Galaxy has been specifically validated in these eyes.

●        A straightforward case, with healthy eyes: either lens will deliver a visual quality profile comparable to a standard single-focus lens — the choice comes down to your priorities and your surgeon’s preference.

Does the surgery itself matter?

Yes — with a premium lens, precision matters.

These lenses perform best when the eye’s measurements are exact and the lens sits perfectly centred.

In selected cases, your surgeon may use femtosecond laser-assisted cataract surgery (FLACS) — for example, the Ziemer FEMTO LDV Z8, which performs key steps of the procedure (the circular opening in the lens capsule and the softening of the cataract) with OCT-guided precision, in a single step without moving you between rooms.

Research shows this adds reproducibility, particularly for lens centration, although it does not replace careful measurements, patient selection and surgical skill.[9]

Femtosecond laser-assisted cataract surgery with the Ziemer FEMTO LDV Z8 at Sandhurst Eye Centre, Johannesburg. (Photograph courtesy of Sandhurst Eye Centre.)

What should you expect after surgery?

Even with the gentlest visual profile, some adaptation is normal. Here is the typical journey:

Timeframe	What to expect
Weeks 1–2	You may notice some halos or glare on your first night drives. Vision can fluctuate slightly day to day.
Weeks 3–6	Halos are already fading for most patients as the brain adapts — a process that works very effectively with refractive lenses.
3 months onwards	93–100% of patients report their halos are not bothersome, and night driving feels natural.[1]

The key message from counselling: if you notice halos in the first weeks, they will shrink and fade — not get worse.

The bottom line

For patients considering cataract surgery in South Africa, purely refractive lenses like the TECNIS PureSee and RayOne Galaxy have changed the conversation. They offer extended or full-range vision with a visual comfort profile closer to a standard lens than to older multifocals — directly addressing the single biggest source of disappointment with premium lenses.

If night driving has been holding you back from a presbyopia-correcting lens, it is worth asking your eye surgeon whether one of these new-generation options is right for you.

Disclosure: This article is based on a presentation delivered by Dr Mark Deist of Sandhurst Eye Centre, Johannesburg, on behalf of Johnson & Johnson Vision. Dr Deist is a paid consultant for Johnson & Johnson. Product indications and availability may vary according to local regulatory requirements. This article is for general information only and does not replace a personal consultation with your ophthalmologist.

References

1. Corbett D, Black D, Roberts TV, et al. Eye (Lond). 2024;38(Suppl 1):9-14.  2. U.S. FDA, SSED: TECNIS PureSee IOL, PMA P980040/S176, 2026.  3. Alfonso-Bartolozzi B, et al. J Refract Surg. 2025;41(4):e333-e341.  4. Rayner Intraocular Lenses, press release, 15 January 2025.  5. Abela-Formanek C, et al. J Refract Surg. 2025;41(11):e1213-e1222.  6. ESCRS Galaxy Era Symposium, September 2025, Copenhagen.  7. Bala C, et al. ASCRS Annual Meeting, April 2025, Los Angeles.  8. Hofstetter HW. Opt World. 1950;38:42-5.  9. Day AC, et al. Ophthalmology. 2020;127(8):1012-9.