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A. R. Bowers, D. Apfelbaum, D. DeCarlo, E. Peli; Use of Bioptic Telescopes by Drivers With Age-Related Macular Degeneration. Invest. Ophthalmol. Vis. Sci. 2007;48(13):2351.
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With the onset of age-related macular degeneration (AMD), older people typically self-restrict their driving or stop driving, with adverse consequences on independence and quality of life. We investigated whether use of a small, spectacle-mounted bioptic telescope reduces self-restriction of driving in this patient group, and evaluated the effect of AMD on self-reported bioptic viewing behaviors.
Drivers with reduced visual acuity, with and without central field loss (CFL), who had recent experience of bioptic driving completed a questionnaire by telephone interview. Bioptic telescope usage patterns were quantified with questions designed specifically for the study. Driving patterns were quantified using the Driving Habits Questionnaire (DHQ) (Owsley et al, 1999). Driving habits data for bioptic drivers with AMD were compared to data from an earlier study (DeCarlo et al, 2003) in which the DHQ had been used to quantify habits of drivers with AMD who drove without bioptic telescopes.
Bioptic drivers from 24 states participated, including 27 with CFL due to AMD, 41 with CFL due to causes other than AMD, and 47 without CFL. Compared to people with AMD driving without bioptic telescopes with similar acuity and age range (n = 28), bioptic drivers with AMD (n = 27) drove greater distances (p < 0.001), to more places (p = 0.001) and reported fewer difficulties with driving in rain, on the highway and in high traffic situations (p < 0.005). Bioptic drivers with CFL reported looking through the telescope for a greater percentage of driving time than bioptic drivers without CFL (medians: 8% (IQR 5-20%) and 5% (IQR 3-8%) p < 0.001). Even though bioptic drivers with CFL due to AMD were older and had less bioptic driving experience (p < 0.001) than bioptic drivers with CFL due to other causes, there were no differences between these two groups in the reported percentage of time looking through the telescope (medians: 8% (IQR 5-18%) and 7% (IQR 5-20%), p = 0.8).
Our results suggest that being permitted to drive with a bioptic telescope reduces self-imposed driving restrictions of people with AMD. Drivers with CFL appeared to use less efficient bioptic viewing behaviors than drivers without CFL. However, older drivers with CFL due to AMD did not report viewing behaviors that seemed any less efficient than younger drivers with other causes of CFL who had greater bioptic driving experience. Objective recordings of bioptic viewing behaviors are needed to verify these findings.
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