First and second eye cataract surgery and driver self-regulation among older drivers with bilateral cataract: a prospective cohort study

Abstract

BackgroundDriving a car is the most common form of transport among the older population. Common medical conditions such as cataract, increase with age and impact on the ability to drive. To compensate for visual decline, some cataract patients may self-regulate their driving while waiting for cataract surgery. However, little is known about the self-regulation practices of older drivers throughout the cataract surgery process. The aim of this study is to assess the impact of first and second eye cataract surgery on driver self-regulation practices, and to determine which objective measures of vision are associated with driver self-regulation.MethodsFifty-five older drivers with bilateral cataract aged 55+ years were assessed using the self-reported Driving Habits Questionnaire, the Mini-Mental State Examination and three objective visual measures in the month before cataract surgery, at least one to three months after first eye cataract surgery and at least one month after second eye cataract surgery. Participants’ natural driving behaviour in four driving situations was also examined for one week using an in-vehicle monitoring device. Two separate Generalised Estimating Equation logistic models were undertaken to assess the impact of first and second eye cataract surgery on driver-self-regulation status and which changes in visual measures were associated with driver self-regulation status.ResultsThe odds of being a self-regulator in at least one driving situation significantly decreased by 70% after first eye cataract surgery (OR: 0.3, 95% CI: 0.1–0.7) and by 90% after second eye surgery (OR: 0.1, 95% CI: 0.1–0.4), compared to before first eye surgery. Improvement in contrast sensitivity after cataract surgery was significantly associated with decreased odds of self-regulation (OR: 0.02, 95% CI: 0.01–0.4).ConclusionsThe findings provide a strong rationale for providing timely first and second eye cataract surgery for older drivers with bilateral cataract, in order to improve their mobility and independence.

Driving Skills Tested on Simulator After Strabismus Surgery: A Prospective Study

“…), which was also the case in previous studies conducted with other ocular diseases. 8 , 13 Strabismus surgery was shown to significantly improve patient self-confidence, as evidenced by a significant improvement in the self-confidence questionnaire for driving. In total, the analysis of self-confidence for the driving questionnaire showed that 80% of patients believed that strabismus surgery had a positive impact on driving ability.…”

“…Patients with cataracts have been found to be more frequently responsible for road accidents than the general population, while reducing their driving time. 8 , 9 Regarding glaucoma, poor on-road driving performance with a trend to spontaneously give up driving has been observed, and simulator-based studies have revealed an increased number of eye movements and driving difficulties in particular conditions (night, fog, rain, and highway). 10 – 13 …”

Impact of first and second eye cataract surgery on physical activity: a prospective study

“…For the CEDAR Study, a total of 111 participants were recruited consecutively from three public hospitals in Western Australia (WA) and completed the first assessment. Previous papers have been published from this study based on the naturalistic driving data collected17–19; a falls diary component20 and further examinations of driving simulator performance are also planned. The current analysis of physical activity outcomes includes only 55 participants who completed the first, second and third assessments.…”

Aggressive Driving Behaviours in Cannabis Users. The Influence of Consumer Characteristics

“…In functional terms, cannabis seems to alter important visual parameters, including visual acuity, contrast sensitivity, colour discrimination, ocular movements, and stereoscopic perception [ 12 , 17 , 21 , 22 , 23 , 24 , 25 ]. Previous evidence has shown that visually impaired drivers adopt some modifications in their driving behaviour as a strategy to compensate for their decreased visual capacity [ 26 , 27 , 28 ]. These modifications include avoiding driving on highways or reducing their speeds [ 26 , 27 , 28 , 29 ].…”