On-Road Driving Performance in Moderate and Advanced Glaucoma Patients

Abstract

 

Purpose:

 

To compare on-road driving performance in patients with moderate and advanced glaucoma to age-matched normal controls.

 

Methods:

 

Glaucoma patients ages 55 years and older with moderate and advanced glaucoma based on the Glaucoma Staging System and a visual acuity of 20/70 or better in the better seeing eye and age-matched normal controls were enrolled. Inclusion required participants to be currently driving with a valid driver’s license and no major comorbid conditions or medications that impair driving. Participants completed an on-road driving evaluation conducted by a masked, certified driving instructor over a 12-mile route through residential and business areas in St. Louis, MO. The driving instructor scored overall driving performance as pass, marginal pass (requiring restrictions or training), or fail and recorded the number of at-fault critical interventions (brake and/or steering intervention) required during the course. A Fisher’s exact test was performed to compare overall driving performance and the number of critical interventions required between glaucoma participants and normal controls.

 

Results:

 

Eighteen glaucoma (71.1 ± 7.1 years) and 28 normal (68.7 ± 8.4 years) participants completed the evaluation. Eight of 18 (44%) glaucoma participants either marginally passed or failed compared to 5 of 28 (18%) normal controls (Fisher’s exact test, p=0.09). Three of 18 (17%) glaucoma participants required 2 or more total critical interventions compared to 0 of 28 (0%) normal controls (Fisher’s exact test, p=0.054).

 

Conclusions:

 

A substantially higher proportion of patients with moderate and advanced glaucoma marginally passed or failed the on-road driving evaluation or required more than one critical intervention compared to individuals without glaucoma. A lack of statistical significance may reflect the small sample size currently collected in this ongoing study.  

 

Keywords: quality of life • clinical (human) or epidemiologic studies: risk factor assessment • aging: visual performance