Glaucoma and Driving Risk under Simulated Fog Conditions

Abstract

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.

Mobile Telephone Use and Reaction Time in Drivers With Glaucoma

“…A random subgroup (50% of participants) responding to the survey was invited to undergo a protocol to investigate the association of mobile telephone use while driving with changes in driving performance. A high-fidelity driving simulator (Realtime Technologies Inc) 1 allowed an assessment of driving performance during situations that would be difficult to recreate in the real world without imposing significant risks to the participants.…”

“…Driving is the main mode of transportation, and the ability to drive is strongly associated with quality of life. 1 , 2 , 3 The National Safety Council's annual injury and fatality report has estimated that the use of mobile telephones while driving is responsible for 26% of motor vehicle crashes. 4 Most of these crashes involve drivers who are distracted by talking on mobile telephones.…”

Gait in Elderly Glaucoma: Impact of Lighting Conditions, Changes in Lighting, and Fear of Falling

“…5 Prior studies describe the impact of reduced contrast on driving and reading performance in patients with glaucoma. 6,7 However, there has been little to no objective study of mobility in nonideal lighting in this population, and data are needed to better S Time elapsed between first contact and last contact for a single footfall of the dominant leg Swing time S Time elapsed between last contact of the dominant leg footfall and first contact of the next dominant leg footfall Base of support cm Distance between the heel center of the dominant foot and the line of progression created by two subsequent heel strikes of the nondominant leg Double support % cycle time % Percentage of stride time during which both feet are contacting the ground substantiate and understand patient complaints. Even among individuals with normal vision, simulated VF constriction impairs navigation more under scotopic conditions.…”

Assessing driving risk in patients with glaucoma

“…For example, using repeated scenarios Adler and colleagues showed that drivers with glaucoma are more susceptible to changing their night driving habits on roads in unknown areas, indicating that the simulator may resemble reality (57) . In another recent study, Diniz-Filho and colleagues found that patients with glaucoma had a higher risk of MVCs during foggy conditions than healthy individuals from the control group in a driving simulator, with a higher risk in patients with a mean deviation from visual field lower than -9 dB (58) .…”