The impact of dry eye disease on vision-related driving ability.

Abstract

Purpose: Visual function was assessed using a dedicated driving simulator together with analysis of tear film-related wavefront aberration dynamics in order to evaluate the impact of dry eye disease (DED) on driving skills.

Methods: A prospective case-control study was conducted in the Center for Clinical Investigation of the Quinze-Vingts National Ophthalmology Hospital, Paris, France. Twenty DED patients and 20 age- and sex-matched control subjects were included. Vision-related driving ability was assessed using a specific driving simulator: randomly displayed targets with progressive increase in contrast had to be identified during a 5-km road circuit in photopic conditions. Other examinations included serial measurements of corneal higher-order aberrations (HOAs) during 10 s after a blink, vision-related quality-of-life questionnaire (Ocular Surface Disease Index [OSDI]), and clinical scoring of DED. Data collected during driving test (number of targets seen, their position, and response time) were compared between groups and analyzed according to the other collected data.

Results: The percentage of targets missed as well as average response time were significantly increased in DED patients as compared with controls (P < .01). Precisely, the visual function of DED patients was more impaired in specific situations such as crossroad or roundabout approaches. In DED patients, the response time was found to positively correlate with the progression index for HOAs (P < .01) and with the OSDI ‘‘symptoms’’ subscale (P<.05).

Conclusions: Tear film-related degradation of ocular optical qualities is associated with visual impairments during driving. This study objectively demonstrates the impact of DED on activities of daily living.

Keywords: 486 cornea: tears/tear film/dry eye • 753 vision and action