Abstract
The objective of this study was to evaluate differences in driving performance, visual detection performance, and eye-scanning behavior between glaucoma patients and control participants without glaucoma. Glaucoma patients (n = 23) and control participants (n = 12) completed four 5-min driving sessions in a simulator. The participants were instructed to maintain the car in the right lane of a two-lane highway while their speed was automatically maintained at 100 km/h. Additional tasks per session were: Session 1: none, Session 2: verbalization of projected letters, Session 3: avoidance of static obstacles, and Session 4: combined letter verbalization and avoidance of static obstacles. Eye-scanning behavior was recorded with an eye-tracker. Results showed no statistically significant differences between patients and control participants for lane keeping, obstacle avoidance, and eye-scanning behavior. Steering activity, number of missed letters, and letter reaction time were significantly higher for glaucoma patients than for control participants. In conclusion, glaucoma patients were able to avoid objects and maintain a nominal lane keeping performance, but applied more steering input than control participants, and were more likely than control participants to miss peripherally projected stimuli. The eye-tracking results suggest that glaucoma patients did not use extra visual search to compensate for their visual field loss. Limitations of the study, such as small sample size, are discussed.
Highlights
Glaucoma can produce severe visual impairment and is the second leading cause of blindness [1]
The data from two glaucoma patients and two control participants was excluded from the analyses
Glaucoma patients performed indistinguishably from control participants on evading obstacles and keeping the car centered in the lane
Summary
Glaucoma can produce severe visual impairment and is the second leading cause of blindness [1]. It has been estimated that 60 million people are currently afflicted with glaucoma, and this number is expected to increase as the population ages [2]. Many glaucoma patients tend to self-regulate their driving activity by avoiding difficult situations such as driving in the dark and rain, or during peak hours [3,4]. Some glaucoma patients with advanced visual field loss continue to drive [4] and may endanger themselves and others. Several studies have shown that glaucoma patients are overrepresented in self-reported and police-registered motor vehicle collisions [5,6,7,8,9]
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