Hazard Perception in Older Drivers With Eye Disease.

Mark S. Horswill,Kaarin J. Anstey,Alex A. Black,Joanne M. Wood

doi:10.1167/tvst.10.1.31

Abstract

PurposeTimely detection of hazards is a key driving skill; however, the hazard perception of drivers with eye disease and related visual changes and the visual predictors of hazard perception are poorly understood.MethodsParticipants included drivers aged 65 years and older with a range of eye diseases, including cataract, age-related maculopathy (AMD), and glaucoma (n = 99; mean age, 75.4 ± 6.4 years) and controls (n = 118; mean age, 72.2 ± 5.5 years). Visual performance was assessed using clinical measures (visual acuity, contrast sensitivity, visual fields) and non-clinical measures (useful field of view, motion sensitivity). Participants completed a computer-based hazard perception test (HPT) that has been related to driving performance and crash risk.ResultsParticipants with eye disease exhibited a 0.73-second delay in HPT response times compared to controls (6.61 ± 1.62 seconds vs. 5.88 ± 1.38 seconds; age-adjusted P = 0.012). Participants with glaucoma exhibited significantly delayed responses compared to those with AMD (P = 0.038) and controls (P = 0.004). Poorer motion sensitivity (standardized β = 0.27; P < 0.001), visual acuity (β = 0.21; P = 0.002), and better-eye mean defect (β = –0.17; P = 0.009) were most strongly associated with delayed HPT responses. Motion sensitivity remained significantly associated with HPT responses, adjusted for visual acuity and visual fields.ConclusionsHPT responses of older drivers with eye disease were delayed compared to controls and translate to an estimated 16-meter longer stopping distance when traveling at 80 km/hr. Decreased motion sensitivity was most strongly associated with delayed HPT responses.Translational RelevanceHPT tests can provide insight into difficulties regarding road hazard detection of older drivers with eye disease and provide a potential avenue for interventions to improve road safety.

Highlights

Older drivers with eye disease and visual impairment have reduced driving ability and safety compared to those with normal vision, as assessed using a range of outcome measures.[1]
One study showed that drivers with age-related macular degeneration (AMD) made more observational errors than controls,[3] whereas drivers with binocular field loss had impaired anticipation skills.[4]
The sample consisted of 217 licensed drivers, including 99 with eye diseases and a control group of 118 visually normal drivers

Summary

Introduction

Older drivers with eye disease and visual impairment have reduced driving ability and safety compared to those with normal vision, as assessed using a range of outcome measures.[1] One important component of driving that is likely to be impacted by visual impairment is hazard perception, which is the ability to anticipate potential road hazards in order to avoid a collision.[2]. On-road studies support the suggestion that drivers with eye disease and associated visual impairment have reduced hazard perception. One study showed that drivers with age-related macular degeneration (AMD) made more observational errors than controls,[3] whereas drivers with binocular field loss (primarily from glaucoma) had impaired anticipation skills.[4] In another study, drivers with mild to moderate glaucomatous loss were more likely to receive a driver instructor intervention that was related to difficulties with detection of peripheral.

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