Driving Self-restriction and Motor Vehicle Collision Occurrence in Glaucoma

Ono, Takaaki; Yuki, Kenya; Awano-Tanabe, Sachiko; Fukagawa, Kazumi; Shimoyama, Masaru; Ozawa, Yoko; Ozeki, Naoki; Shiba, Daisuke; Tsubota, Kazuo

doi:10.1097/opx.0000000000000493

Cited by 14 publications

(13 citation statements)

References 44 publications

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“…For example, while some studies have shown that increased severity of glaucomatous visual field loss is linked with elevated state-recorded [8, 10, 11] and self-reported [9, 12] crash rates, as well as poorer open-road driving performance [13], another failed to find a significant association between the extent of glaucomatous binocular field loss and on-road driving performance [14]. Indeed, in the latter study [14], alterations in oculomotor behaviour, particularly through increased glances towards areas of visual field loss, were found to be associated with better driving ability and safety among drivers with glaucoma.…”

Section: Introductionmentioning

confidence: 99%

Effect of glaucoma on eye movement patterns and laboratory-based hazard detection ability

2017

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PurposeThe mechanisms underlying the elevated crash rates of older drivers with glaucoma are poorly understood. A key driving skill is timely detection of hazards; however, the hazard detection ability of drivers with glaucoma has been largely unexplored. This study assessed the eye movement patterns and visual predictors of performance on a laboratory-based hazard detection task in older drivers with glaucoma.MethodsParticipants included 30 older drivers with glaucoma (71±7 years; average better-eye mean deviation (MD) = −3.1±3.2 dB; average worse-eye MD = −11.9±6.2 dB) and 25 age-matched controls (72±7 years). Visual acuity, contrast sensitivity, visual fields, useful field of view (UFoV; processing speeds), and motion sensitivity were assessed. Participants completed a computerised Hazard Perception Test (HPT) while their eye movements were recorded using a desk-mounted Tobii TX300 eye-tracking system. The HPT comprises a series of real-world traffic videos recorded from the driver’s perspective; participants responded to road hazards appearing in the videos, and hazard response times were determined.ResultsParticipants with glaucoma exhibited an average of 0.42 seconds delay in hazard response time (p = 0.001), smaller saccades (p = 0.010), and delayed first fixation on hazards (p<0.001) compared to controls. Importantly, larger saccades were associated with faster hazard responses in the glaucoma group (p = 0.004), but not in the control group (p = 0.19). Across both groups, significant visual predictors of hazard response times included motion sensitivity, UFoV, and worse-eye MD (p<0.05).ConclusionsOlder drivers with glaucoma had delayed hazard response times compared to controls, with associated changes in eye movement patterns. The association between larger saccades and faster hazard response time in the glaucoma group may represent a compensatory behaviour to facilitate improved performance.

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Section: Introductionmentioning

confidence: 99%

Effect of glaucoma on eye movement patterns and laboratory-based hazard detection ability

2017

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“…Another observational study that compared the MVC risk of drivers with and without glaucoma, found that MVC risk was actually lower in those with glaucoma; however, the extent of field loss was not reported and it is possible that drivers with glaucoma may have compensated for their field loss by self‐regulating their driving behaviour. As described above, self‐regulation of driving is associated with reduced prevalence of self‐reported collisions, although this was only evident in the male drivers in that study …”

Section: Glaucomamentioning

confidence: 63%

“…Glaucoma has been associated with a number of self‐reported driving difficulties, including problems with glare, driving at night and tasks requiring peripheral vision and visual search . Self‐reported driving ability is also reduced in drivers with glaucoma who report avoiding challenging driving situations; this is associated with reduced prevalence of self‐reported crashes in men but not women . Importantly, glaucoma is cited as one of the main reasons that older drivers cease driving, with one study reporting that those with bilateral glaucoma were almost three times more likely to cease driving than those without glaucoma …”

Section: Glaucomamentioning

confidence: 99%

“…As described above, selfregulation of driving is associated with reduced prevalence of self-reported collisions, although this was only evident in the male drivers in that study. 39 Collectively, the research suggests that for glaucomatous patients, early detection is critical not just to minimise visual field loss but also to maintain driving performance at safe levels. Evidence from crash studies suggests that MVC risk generally does not increase above that of controls until glaucomatous loss is at moderate to severe levels and on-road studies suggest that lanekeeping and anticipatory skills are a particular problem.…”

Section: Ocular Disease and Driving Wood And Blackmentioning

confidence: 99%

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Ocular disease and driving

Wood

Black

2016

Clinical and Experimental Optometry

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As the driving population ages, the number of drivers with visual impairment resulting from ocular disease will increase given the age-related prevalence of ocular disease. The increase in visual impairment in the driving population has a number of implications for driving outcomes. This review summarises current research regarding the impact of common ocular diseases on driving ability and safety, with particular focus on cataract, glaucoma, age-related macular degeneration, hemianopia and diabetic retinopathy. The evidence considered includes self-reported driving outcomes, driving performance (on-road and simulator-based) and various motor vehicle crash indices. Collectively, this review demonstrates that driving ability and safety are negatively affected by ocular disease; however, further research is needed in this area. Older drivers with ocular disease need to be aware of the negative consequences of their ocular condition and in the case where treatment options are available, encouraged to seek these earlier for optimum driving safety and quality of life benefits.

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“…35 Ono et al 36 showed that, among 252 glaucoma subjects, 18% avoided driving in fog. However, in a recent study (Correa PC, et al IOVS 2016:57:ARVO E-Abstract 3420), we showed that there is only a relatively weak relationship between subjective concerns about driving ability and objective driving performance in patients with glaucoma.…”

Section: Discussionmentioning

confidence: 99%

Glaucoma and Driving Risk under Simulated Fog Conditions

Diniz-Filho

Boer

Elhosseiny

et al. 2016

Trans. Vis. Sci. Tech.

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PurposeWe evaluate driving risk under simulated fog conditions in glaucoma and healthy subjects.MethodsThis cross-sectional study included 41 glaucoma patients and 25 age-matched healthy subjects who underwent driving simulation. Tests consisted of curve negotiation without and with fog preview at 30 m of distance and two controlled speeds (slow and fast). Inverse time-to-line crossing (invTLC) was used as metric to quantify risk; higher invTLC values indicating higher risk, as less time is available to avoid drifting out of the road. Piecewise regression models were used to investigate the relationship between differences in invTLC in fog and nonfog conditions and visual field loss.ResultsGlaucoma patients had greater increase in driving risk under fog compared to controls, as indicated by invTLC differences (0.490 ± 0.578 s−1 and 0.208 ± 0.106 s−1, respectively; P = 0.002). Mean deviation (MD) of the better eye was significantly associated with driving risk under fog, with a breakpoint of −9 dB identified by piecewise regression. For values below the breakpoint, each 1 dB lower MD of better eye was associated with 0.117 s−1 higher invTLC under fast speed (adjusted R2 = 57.9%; P < 0.001).ConclusionsGlaucoma patients have a steeper increase in driving risk under fog conditions when compared to healthy subjects, especially when the severity of visual field damage falls below −9 dB of MD in the better eye.Translational RelevanceBy investigating the relationship between driving risk and disease severity breakpoint, this study may provide guidance to clinicians in recognizing glaucoma patients who may be unfit to drive in complex situations such as fog.

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Driving Self-restriction and Motor Vehicle Collision Occurrence in Glaucoma

Abstract: Driving self-restriction may be associated with a reduced prevalence of MVCs in men with POAG.

Cited by 14 publications

References 44 publications

Effect of glaucoma on eye movement patterns and laboratory-based hazard detection ability

Effect of glaucoma on eye movement patterns and laboratory-based hazard detection ability

Ocular disease and driving

Glaucoma and Driving Risk under Simulated Fog Conditions

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