The basic rule of cycling at night and blinded by headlights... never ride into the light!!!
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I've had troubles, usually near the end of 150 to 185 mile rides. Just trying to keep the pedals moving.
The worst was one where I had gotten my main headlight stolen a few weeks earlier and was riding on a backup light. I managed to hit some animal that I never saw in the dark, but it knocked me flat.
I think I had hyper-extended my elbow. Anyway, I was in a lot of pain for the last 50 miles or so. By the last 10 miles I started hitting dawn traffic, and found it very hard to keep my line straight on the road, and being blinded by lights just made it worse.