Driving Performance of Glaucoma Patients Correlates With Peripheral Visual Field Loss

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Purpose:To identify clinical vision measures that are associated with the driving performance of glaucoma patients who have visual field loss and visual acuity better than 20/100 and to compare the driving performance of glaucoma patients with the driving performance of a group of age- and sex-equivalent individuals without eye disease.Patients:Forty patients with glaucoma and 17 normally sighted control subjects participated in this study.Methods:Clinical vision data, consisting of visual acuity, letter contrast sensitivity, and visual fields, were collected. Driving performance was assessed by (1) an interactive driving simulator that measured 7 indices of performance (including number of accidents) and (2) the self-reported accident involvement for the past 5 years.Main Outcome Measures:Driving simulator performance and real-world, self-reported accident involvement.Results:The number of accidents as measured on the driving simulator in the glaucoma group was significantly correlated with three Goldmann visual field measures: combined horizontal extent (ρ = −0.47, P = 0.01), total horizontal extent (ρ = −0.49, P = 0.007), and total peripheral extent (ρ = −0.55, P = 0.002). There were no statistically significant correlations between the driving performance of the glaucoma group and the visual acuity or contrast sensitivity measures. When compared with the control group, a significantly greater proportion of the glaucoma group reported having at least one real-world accident within the past 5 years (Fisher exact test, P = 0.005).Conclusions:Visual field reduced to less than 100° of horizontal extent may place patients with peripheral field loss at greater accident risk. A higher incidence of real-world and simulator accidents was found for the group with glaucoma.

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