Abstract
Purpose :
To determine how severity of glaucoma affects driving performance in older adults and compared to controls.
Methods :
A total of 157 participants (111 glaucoma and 46 controls), ages 55 years and older, were recruited from the Washington University School of Medicine Eye Clinics. Participants completed a comprehensive panel of clinical assessments and a standardized on-road driving assessment. Glaucoma participants were categorized into mild (n=54), moderate (n=43) and advanced (n=14) severity based on a modified Hodapp-Anderson-Parrish classification system of their better eye. The risk of driving impairment was determined by a qualitative driving score (pass vs. marginal/fail), total number of critical interventions required, total number of driving errors, and lane maintenance and visual scanning errors.
Results :
Thirty percent of glaucoma participants received a marginal/failing driving score compared to 4% of controls. Percent of participants with marginal/failing scores increased from controls (4%) to participants with mild (17%), moderate (37%) and advanced (57%) glaucoma (p=<0.0001). Similar increases between controls and participants with mild, moderate and advanced glaucoma were found for total number of required critical interventions (p=0.03), total driving errors (p=0.003), and errors in lane maintenance (p=0.0005), but not with visual scanning (p=0.34).
Conclusions :
In older adult drivers, those with glaucoma have a higher risk of driving impairment than those without glaucoma. Higher risk of driving errors begins as early as the mild stage and increases with worse glaucoma severity. Identifying specific driving errors associated with driving impairment, such as lane maintenance, can be used to develop programs to improve driving safety in older adults with glaucoma.
This is a 2020 ARVO Annual Meeting abstract.