Is glaucoma associated with motor vehicle collision involvement and driving avoidance?

Abstract

Abstract: : Purpose: To evaluate the association between glaucoma and motor vehicle collision (MVC) involvement and driving avoidance using a retrospective cohort study design for the period 1994–1999. Methods: Two groups of patients (age ≥ 55yo) who were licensed drivers were identified through university–affiliated ophthalmology and optometry practices –– those with glaucoma (n=576) and those without (n=115). Demographic, clinical, and driving habits were obtained via chart abstractions and patient interviews with standard instruments. Information about MVC involvement was obtained from Department of Public Safety records. Results: Adjusting for demographic, medical and visual acuity characteristics, glaucoma patients had a lower MVC rate (RR 0.67, 95% CI 0.47–0.97) than that of non–glaucoma patients. When crashes were limited to at–fault, there was no difference seen between MVC rates for glaucoma and non–glaucoma patients (RR 1.22, CI 0.67–2.22). Glaucoma patients had significantly higher levels of self–reported avoidance of challenging driving situations such as at night (OR 2.06, CI 1.11–3.82), in fog (OR 3.80, CI 1.93–7.48), in rain (OR 3.99, CI 1.32–6.76), rush hour (OR 2.24, CI 1.16–4.34), on the highway (OR 2.81, CI 1.19–6.64), and in high–density areas (OR 2.88, CI 1.28–6.46). Conclusions: Older adults with glaucoma are at least as safe on the road, if not safer, than older drivers without this condition. Results imply that drivers with glaucoma may be self–limiting their exposure to the road in response to their disease. However, further analysis of our data indicate that the reduced crash rate of glaucomatous drivers cannot be explained by their tendency to avoid challenging driving situations

Keywords: clinical (human) or epidemiologic studies: outcomes/complications • visual fields • quality of life