Risk of auto accidents in patients with moderate-stage glaucoma

Abstract

Purpose : To evaluate factors related to motor vehicle accidents (MVA) in patients with moderate glaucoma. Operating motor vehicles with decreased vision due to glaucoma presents a greater risk of injuries and mortality.

Methods : Patients diagnosed with moderate glaucoma were prospectively examined annually for 5 visits over four years. Clinical assessment included visual acuity (VA), visual field (VF), and contrast sensitivity tests. Compressed assessment of ability related to vision (CAARV) was used to track performance-based visual function, and the National Eye Institute Visual Function Questionnaire (NEI VFQ-25) measured vision-related quality of life (QoL). The number of self-reported MVA and fault during the time between each annual visit were captured. Mixed effects logistic regression models were created using SAS/STAT version 14.2.

Results : A total of 142 glaucoma patients reported driving and were included in our analysis. The mean (±SD) age was 64.24 (8.96) years. The rate of MVA in driving participants increased between visits 1 through 4 (5.8% to 10.8%) before decreasing to 5.9% at visit 5. These rates are considerably higher than the 1.1% reported in the 2017 Pennsylvania Crash Facts and Statistics for drivers over 61 years old. In the initial univariable mixed effects logistic regression model, increased odds of self-reported MVA were associated with lower: mean deviation (MD) in the worse eye (p= <.001), bilateral VA (p= 0.017), worse eye SPARCS score (p= <.001), and total CAARV (p= 0.073). In the final multivariable model, only lower MD in the worse eye was significantly associated with greater odds of auto accidents (OR=1.09; 95% CI 1.03-1.14; P<.001).

Conclusions : Auto accidents in patients with moderate-stage glaucoma are common. Lower MD in the worse eye was found to be an independent risk factor for MVA in patients with moderate glaucoma. Identifying individuals at risk may help prevent recurrent accidents by educating providers and patients with glaucoma regarding their safety and fitness to drive.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.