Glaucoma and on-road driving performance

Haymes, Sharon A., LeBlanc, Raymond P., Nicolela, Marcelo T., Chiasson, Lorraine A. and Chauhan, Balwantray C. 2008, Glaucoma and on-road driving performance, Investigative ophthalmology and visual science, vol. 49, no. 7, pp. 3035-3041, doi: 10.1167/iovs.07-1609.

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Title Glaucoma and on-road driving performance
Author(s) Haymes, Sharon A.
LeBlanc, Raymond P.
Nicolela, Marcelo T.
Chiasson, Lorraine A.
Chauhan, Balwantray C.
Journal name Investigative ophthalmology and visual science
Volume number 49
Issue number 7
Start page 3035
End page 3041
Total pages 7
Publisher Association for Research in Vision and Ophthalmology
Place of publication Rockville, Md.
Publication date 2008-07
ISSN 0146-0404
Summary PURPOSE. To investigate the on-road driving performance of patients with glaucoma.

METHODS. The sample comprised 20 patients with glaucoma and 20 subjects with normal vision, all licensed drivers, matched for age and sex. Driving performance was tested over a 10-km route incorporating 55 standardized maneuvers and skills through residential and business districts of Halifax, Nova Scotia, Canada. Testing was conducted by a professional driving instructor and assessed by an occupational therapist certified in driver rehabilitation, masked to participant group membership and level of vision. Main outcome measures were total number of satisfactory maneuvers and skills, overall rating, and incidence of at-fault critical interventions (application of the dual brake and/or steering override by the driving instructor to prevent a potentially unsafe maneuver). Measures of visual function included visual acuity, contrast sensitivity, and visual fields (Humphrey Field Analyzer; Carl Zeiss Meditec, Inc., Dublin, CA; mean deviation [MD] and binocular Esterman points).

RESULTS. There was no significant difference between patients with glaucoma (mean MD = −1.7 dB [SD 2.2] and −6.5 dB [SD 4.9], better and worse eyes, respectively) and control subjects in total satisfactory maneuvers and skills (P = 0.65), or overall rating (P = 0.60). However, 12 (60%) patients with glaucoma had one or more at-fault critical interventions, compared with 4 (20%) control subjects (odds ratio = 6.00, 95% CI, 1.46–24.69; higher still after adjustment for age, sex, medications and driving exposure), the predominant reason being failure to see and yield to a pedestrian. In the glaucoma group, worse-eye MD was associated with the overall rating of driving (r = 0.66, P = 0.002).

CONCLUSIONS. This sample of patients with glaucoma with slight to moderate visual field impairment performed many real-world driving maneuvers safely. However, they were six times as likely as subjects with normal vision to have a driving instructor intervene for reasons suggesting difficulty with detection of peripheral obstacles and hazards and reaction to unexpected events.
Language eng
DOI 10.1167/iovs.07-1609
Field of Research 119999 Medical and Health Sciences not elsewhere classified
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1.1 Refereed article in a scholarly journal
Copyright notice ©2008, Association for Research in Vision and Ophthalmology
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