Dry eye and Changes in Driving Habits: The Salisbury Eye Evaluation

Abstract

 

Purpose

 

To evaluate the association between dry eye symptoms (DES) and clinically significant dry eye (CSDE) with self-reported driving limitations.

 

Methods

 

A population-based sample of 1,896 current or previous drivers (ages 65 to 84), with visual acuity better than 20/40 and no significant visual field loss, were asked if they had driven: (1) at all in the last year, (2) at least 3000 miles in the last year, (3) at night in the last 3 months, or (4) in unfamiliar areas over the last 3 months. DES were defined as one or more self-reported dry eye symptom occurring often or always, while CSDE was defined as the presence of DES plus clinical evidence of dry eye based on Schirmer’s or rose bengal staining. Associations between DES and CSDE with driving cessation and driving restrictions were assessed in multivariable models adjusting for demographic, visual, and health-related factors.

 

Results

 

From the eligible subjects, 275 (11%) had DES and 92 (4%) had CSDE. Univariate analysis showed that subjects with DES, compared to subjects without DES, were more likely to cease driving (14.3% vs. 8.0%, p=0.001), to drive <3000 miles/year (36.5% vs. 26.8%, p=0.002), to not drive at night (26.2% vs. 20.1, p=0.03), but were not more likely to avoid driving in unfamiliar areas (51.7% vs. 50.4%, p=0.7). Subjects with CSDE, compared to subjects without CSDE, trended toward higher likelihood of driving cessation (14.5% vs. 8.6%, p=0.09), but not driving limitations (p>0.19 for all). Multivariable analysis demonstrated that the presence of DES was associated with a 1.8-fold greater odds of driving cessation (95% CI=1.2-2.9; p=0.008) and a greater likelihood of driving less than 3000 miles per year (Odds Ratio [OR]=1.6; 95% CI=1.1-2.2; p=0.007). Subjects with CSDE had a 2.4-fold greater odds of driving cessation when compared with subjects without any signs or symptoms (95% CI=1.1-5.1; p=0.02). Neither DES nor CSDE was significantly associated with the other driving limitations (p>0.13 for all).

 

Conclusions

 

Assessment and treatment of dry eye may prevent significant changes in driving habits or driving cessation, ultimately with improvement of independence and quality of life.

 

 

Percent of subjects who ceased driving, stratified by the number of dry eye symptoms(DES)

 

Keywords: 414 aging: visual performance • 669 quality of life • 459 clinical (human) or epidemiologic studies: biostatistics/epidemiology methodology