Citation

Bowers AR, Mandel AJ, Goldstein RB, Peli E. Invest. Ophthalmol. Vis. Sci. 2009; 50(11): 5137-5147.

Affiliation

Harvard Medical School, Schepens Eye Research Institute, Boston, Massachusetts, United States.

Copyright

(Copyright © 2009, Association for Research in Vision and Ophthalmology)

DOI

10.1167/iovs.09-3799

PMID

19608541

PMCID

PMC2783572

Abstract

Purpose: This study was designed to examine the effect of homonymous hemianopia (HH) on detection of pedestrian figures in multiple, realistic and hazardous situations within the controlled environment of a driving simulator. Methods: Twelve people with complete HH, and without visual neglect or cognitive decline, and twelve matched normally-sighted (NV) drivers participated. They drove predetermined city and rural highway routes (total 120 minutes) during which pedestrian figures appeared at random intervals along the roadway (R-Peds; n = 144) and at intersections (I-Peds; n = 10). Detection rates and response times were derived from participant horn-presses. Results HH drivers exhibited significantly (p < 0.001) lower R-Ped detection rates on their blind side than NV drivers (range 6% to 100%). Detection of I-Peds on the blind side was also poor (8% to 55%). Age and blind-side detection rates were negatively correlated (Spearman r = 0.71, p = 0.009). Although blind-side response times of HH drivers were significantly (p < 0.001) longer than NV drivers, most were within a commonly-used 2.5s guideline. Conclusions: Most HH participants had blind-side detection rates that seem incompatible with safe driving; however, the relationship of our simulator detection performance measures to on-road performance has yet to be established. In determining fitness to drive for people with HH, our results underscore the importance of individualized assessments including evaluations of blind-side hazard detection.

Language: en